Crucial Accountability is the second edition of Crucial Confrontations, one of several practical books by VitalSmarts. This easy-to-read book takes the concepts addressed in Crucial Conversations one step further and offers tools for holding ourselves and others accountable. Sometimes it is easier to not speak up and hold others accountable for a performance gap, but Crucial Accountability provides practical advice on how to have these difficult conversations. In the health care arena, the trend toward silence has a devastating impact. When we witness a colleague about to make an error—a break in a sterile technique, a failure to check a patient identification, a failure to verify a dose of a high-risk medication—and we do not speak up, our silence puts patients at risk, erodes trust, and perpetuates the problem.

As stated in Crucial Conversations, the first step is to examine our...

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