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With rising inflation, high healthcare costs, and a tight labor market, businesses are looking for solutions to keep their employees engaged and increase productivity.

Sam Silverstein, author, and founder of the Accountability Institute, spoke at The Alliance’s 2023 Spring Symposium: Commitment to a Healthy Workforce, to teach employers how creating a culture of accountability can help build trust, foster productivity, and retain talent. When organizations create a culture of accountability, especially when it comes to the health and well-being of their employees, they position themselves to manage change, implement critical initiatives, and create high-performing organizations.

What is Accountability?

Silverstein defines accountability as, “keeping your commitments to people.” Being accountable to your employees means doing what you say you’re going to do no matter what. In other words, commit to your people and stand by them when things go wrong. Whether it’s a mistake on the job or a health or family issue. If you’re authentically there for your people, they will be there for you and your business.

Accountability is the highest form of leadership. It cannot be forced or mandated, it can only be inspired. So, instead of thinking about how you can get your employees to be accountable, think about how you are accountable for your employees and how you show it.

Creating a culture of accountability is a worthy business venture because an accountable culture translates to happier, healthier employees. Healthy, happy employees are able to take care of themselves and their families and when employees are not stressed about their health and the health of their families, they are able to work more efficiently. When employees know their organization’s leadership genuinely cares about them, they care about their organization. If you are committed to your people, they will be committed to you.

What Does it Mean to Be Accountable for and Accountable to?

When you’re accountable to someone, it means an individual is responsible for some aspect of your well-being. For example, employees are accountable to their supervisors because they rely on them for their paycheck and a positive work environment. Children are accountable to their parents because they rely on them to meet their needs. On the other hand, when you’re accountable for someone, you’re responsible for some aspect of that person’s well-being – you affect their life beyond surface-level interaction. Parents are accountable for their children because they are responsible for meeting their needs.

Leaders have a kind of stewardship relationship with their employees where they are both accountable for and accountable to their people. Effective leaders think about how they can serve their employees and help them reach their full potential while acknowledging the reciprocal nature of the relationship.

What are the Commitments of Accountability?

To be accountable, you need to fulfill both tactical and relational commitments. Tactical commitments are practical obligations such as assigned work tasks. Relational commitments are promises you make to people. Fulfilling a relational commitment means showing up for your employees and making their growth and professional development a priority.

Relational commitments have a significant impact on an organization because when people feel they are valued, they are more likely to take pride in their work and be loyal to their organization. Leaders who commit to guiding their employees to their full potential, and follow through, will see an increase in retention because their employees feel truly valued and understood. This also reduces turnover and decreases onboarding costs.

When leaders create a safe work environment – both physically and emotionally – people will have a positive work experience. When they have a positive work experience, they are more likely to recommend it to their friends and loved ones. So, creating a culture of accountability can also be a great way to get organic, qualified applicants.  

How Can I Build an Accountable Culture by Design?

Workplace culture is what is accepted and repeated. Silverstein said, “What you allow in your space, you condone. What you condone, you are creating.”

There are two types of workplace culture – a culture by default and a culture by design. A culture by default is the most common type of workplace culture. It’s the “lowest-common-denominator culture,” a culture where “anything goes.” This type of culture happens when leaders do not properly define the culture and/or do not maintain the culture. An organization with a culture by default cannot function optimally. Eventually, employees will leave for an organization with a better culture, a culture by design.

People want to work in a positive environment, and they want to feel some kind of fulfillment from their work. Organizations that people want to work for are organizations that have created and maintained a culture people want to be a part of. So, creating a culture by design is a big advantage when it comes to attracting and retaining the best employees.  

Sam defined five critical steps to build a culture by design that focuses on employee health and well-being:


The first step in creating a culture by design is clearly defining your organizational values and committing to them. Organizational leaders are accountable for what the company values. People operate at the level of the culture so if you have a poorly defined culture and values, employees will operate at that level. If you put in the effort to create a culture of excellence, employees will rise to meet the culture.


As accountability cannot be mandated, only inspired, it is important for leaders to embody the culture and model it in their daily lives. If organizational leaders are not modeling the values, the values will not become part of the culture and the culture will erode to a culture by default. If living a healthy lifestyle is a core company value, employees need to see organizational leaders prioritizing their health and wellness. For example, by taking time out of their workday to exercise.


Everyone in an organization needs to consistently live the company values for the culture to succeed. Leaders need to make sure employees understand the values, their importance, and the consequences of not living them through ongoing conversations and reinforcement. Leaders need to make sure employees understand that learning the values is a continuous process.


The work that went into defining and building the culture can be undone by “a single person who refuses to live the values or fulfill relational commitments.” Everyone needs to live up to the values and if someone does not, there need to be consequences. If you say breaking a company value is non-negotiable and then don’t follow through when someone breaks the value, you are undermining the values and creating opportunities for others to do so as well.


In addition to defining, modeling, teaching, and protecting the culture, it’s important to celebrate the culture your organization has created. “Celebrating the culture is equal parts celebrating your values and celebrating your people. At the end of the day, you are celebrating both!” It’s important for everyone in an organization to take pride in the culture and commend when employees live the values.

How Can I Apply Accountability to My Health Plan?

People work to find fulfillment and to be able to take care of themselves and their families. So, a powerful way employers can show their accountability for their employees is through an effective health plan. By offering beyond what is legally required and thinking about what benefits employees really need and want, employers can demonstrate their respect for their employees and their understanding of their needs.

When you build health and wellness into your values and create a culture that allows your employees to take care of themselves and their families, you will see increased productivity and happier, more loyal employees. It’s possible for employees to work hard, take care of their loved ones, and enjoy their lives to the fullest. It doesn’t have to be one or the other.  

Visit our Events page to watch the highlights of Sam Silverstein’s presentation and learn strategies you can apply to your health plan from our expert panel.


Health & Wellness


Events by the Alliance Members & Employers


Health & Wellness


Events by the Alliance Members & Employers
Jennifer Austin

Jennifer Austin
Senior Director of Strategic Marketing and Employer Engagement

Jennifer Austin is the Senior Director of Strategic Marketing and Employer Engagement at The Alliance. She leads the marketing and account management teams in all aspects of marketing and customer engagement, including brand strategy, paid advertising, public relations, social media, website development and optimization, and events. Her account management team manages over 425+ employer-members who serve for over 118,000 employees, getting them access to the best care at the best price. Prior to joining The Alliance, Jennifer worked at a number of agencies in Chicago and Madison, including Healthgrades, focusing on marketing and strategy development for hospitals and health systems, including Advocate Healthcare (now Advocate Aurora Health), Augusta University Health, and HCA Healthcare. Jennifer has nearly 20 years of experience in marketing and advertising. She earned her master’s degree in Global Marketing, Communications and Advertising from Emerson College and her bachelor’s degree in Art and English from The University of Iowa.

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