Navigating Accountable Conversations in Health Care: Balancing Power Dynamics

Effective communication is crucial in health care and contributes to safe patient care and organizational excellence. Hierarchical differences can negatively affect communication among clinicians; however, recognizing and addressing power imbalances can improve patient safety. Individuals can feel empowered to express concerns and provide constructive feedback through clear communication with active listening. Perioperative nurses and leaders can use a variety of strategies to enhance accountable (or critical) conversations, such as structured communication models that guide participants through conversations and standardized procedures and tools to enhance the quality of team communication. This article provides an overview of accountable conversations, discusses the importance of structured communication models, and offers scenario-based examples using two structured models to enhance the reader's understanding. Finally, the article describes cultural competence and the leader's role in developing a culture of accountability.