How to Achieve Team Accountability with ARCC

By Gerard Johnson, M.S. February 25, 2021

We were forced to make some tough choices in 2020 and our employees endured everything from fear of losing their jobs to fear of losing their lives. In response, practice leaders focused employee engagement to retain talent and boost overall morale in our offices. Employee performance and accountability often became less important. However, employee accountability is employee engagement. Everyone wants to know that their actions matter and that you care enough to make sure that everyone is buying into the culture of excellence. Introducing ARCC to your practice is a great way to reduce mistakes but also teach your team how to resolve small lapses in performance. 

ARCC stands for Ask a Question, Request a Change, Communicate your Concern, and Chain of Command. This technique is simple and can be taught in a single practice meeting by simply introducing the ideal and going through different role-playing scenarios.

ARCC gives your team a way to communicate their concerns to one another when they see a lapse. They can hold each other accountable while not appearing to be bossy and overstepping their boundaries.

The ARCC method of accident prevention gives your team the communication tools to hold each other accountable without bossing each other around. Hospital systems around the country currently use this technique to prevent hurt, harm or danger from befalling their patients. 

Ask a Question

The first step is asking a question if you see someone making a mistake. Always emphasize the importance of using the lightest touch. Ask a non-judgmental question. Tone is the key. If your tone is too sharp people put up their defenses and refuse to answer and if your tone is too light, then people ignore your concerns. I always teach my staff to first ask the person if they have time to answer the question. Can I ask you a question? Do you have a minute? Can I ask a clarifying question? I am unsure what you mean, can you rephrase that? Half the time mistakes are made not maliciously, but out of ignorance and miscommunication. People generally want to do a good job and be a good teammate. Sometimes people just need to step back and think through their actions.

Role play scenario 1: You notice a teammate did not answer the voicemails before they left for the night? How would you use the “A” in ARCC?

Role Play scenario 2: You notice that the optician responsible for processing orders with the lab order a high index 1.67 lens for a patient when the order form says it should be standard polycarbonate. How do you use the “A” in ARCC?

Request a Change

Teaching your team to be comfortable with requesting a change probably won’t be as challenging as it seems. The key to requesting a change is, again, having a light touch. Encourage your team to use the words “can we try” when requesting a change. If key phrases are used habitually, they’ll become familiar amongst the team and remove some of the stress of asking for a change.

Role Play Scenario: You notice that the front office specialist, FOS, is only getting one phone number when they are registering patients. The rule is that you should have both the home and cell number. You ask why and the response you get is that they don’t see why it matters since we have a number to contact the patient. How should you request a change in this situation?

Communicate your Concern

You have asked the question and you requested a change to no avail. The next step is to communicate your concern. There is a chance the person you are trying to get to make a change still does not understand the gravity of the situation or why it is important to make a change.

Role Play Scenario: You have asked the FOS kindly why they are only getting home phone numbers and request nicely and professionally that they change, but they refuse to change. How should you communicate your concern that patients may not be getting their notifications? How do you communicate that patient orders are ready or patients have upcoming appointments if you do not have complete contact information? Now it’s time to communicate the concern. We must explain that without the cell phone number we are not able to text the patient to notify them that their glasses are ready for pickup. Having multiple ways to communicate with patients will help front desk staff to reach patients. By communicating the concern clearly and kindly, the front desk staff understands that they are in fact making more work for themselves by not taking the extra step of collecting both numbers.

Chain of Command

What if clearly communicating your concerns still does not work? The next step is to bring the matter higher up the chain of command. You need to make sure that your team is clear on the chain of command for escalating issues. Clarity and  comfort go hand in hand.  

Employee accountability is employee engagement. Employees want feedback. They want to know if they are making mistakes and expect one set of standards for all employees. Nothing kills team morale like everyone thinking that bad behavior is excused and ignored. People also want to know that they can come to leadership if something isn’t right and that leadership will tackle these issues head on. Teaching your team how to effectively apply ARCC will help your team feel comfortable self-correcting minor issues.

I also recommend The Greatest Gift Ever game as a great way to introduce the principles of asking questions with clarity and kindness.  Knowing there is a process and vocabulary to help convey concerns will make employee accountability a little less stressful and employee engagement a lot easier.

Gerard Johnson, M.S.

Gerard is a writer, trainer, and leader who has worked in healthcare since 2003. He has managed and trained teams in Optometry, Ophthalmology, and Family Medicine. Gerard currently works as a practice manager for a family practice in Atlanta, GA.

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