"Managing up" can improve teamwork in the OR.

Holding each team member accountable for following policies and behaving professionally in the work environment should be the responsibility of all perioperative personnel, not just the department manager. A culture in which employees "manage up" is one in which they communicate with each other in respectful ways and feel comfortable correcting each other when they see negative behaviors or inconsistencies in patient care delivery. Creating a culture in which employees feel empowered to manage up requires education, support of management, and staff member assertiveness. Ultimately, individual accountability and effective teamwork can help ensure patient safety.