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What are some of the ways you have seen employers measure the accountability of their staff?

What are some of the ways you have seen employers measure the accountability of their staff? Were these measurements effective? Why or why not? Why is measurement of accountability important to an organization?
What tools and techniques would you use to motivate your staff if you were the head of a nursing home? Would your tools and techniques differ if you were the head of a hospital? Why do you think those tools and techniques would work or not work given your specific environment?

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