From “I Will” to I do.

Teach the commitment. Observe the behavior. Sustain the practice.

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COMMITMENT 07

I Will lead with integrity and compassion, especially when decisions are difficult.

Learning objective: Explain a difficult decision honestly while recognizing its human impact.

1. Understand the commitment

Integrity means explaining what is known, what remains uncertain, and the real constraints affecting a decision. Compassion means acknowledging how that decision affects people and offering practical support. Neither requires avoiding difficult choices. Apply a consistent process, invite challenge, disclose relevant conflicts through local channels, and correct the record when your assumptions prove wrong.

Observable behaviors

Explain the rationale, constraints, and uncertainties honestly.
Acknowledge the effect on patients and staff and discuss support.
Invite challenge and revisit the decision when evidence changes.

Describe a recent moment when this commitment was difficult. What could an observer have seen or heard you do?

2. Practice and reflect

A service reduction is unavoidable under current staffing. Staff ask why. What is the strongest response?

Choose the strongest leadership response Say the change will benefit everyone even though access will decrease. Explain the staffing constraint and tradeoffs, listen to the effects, and agree on support and a review date. Avoid discussion because the decision is already made.

Read the facilitator’s explanation

Honest explanation and practical support can coexist with a difficult decision. Naming the review date makes the decision open to reassessment.

Reflect: What uncomfortable fact did you explain, and how did you respond to the people affected?

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3. Observe and coach

Choose the behavioral level supported by your evidence. Unobserved commitments remain unscored.

Coach assessment1BeginningRecognizes an ethical tension with guidance.2DevelopingExplains part of a decision but avoids uncertainty or human impact.3ConsistentCommunicates honestly, applies a fair process, and offers practical support.4SustainingModels transparent reconsideration and improves how the team handles difficult decisions.

Evidence to look for

A de-identified decision rationale, alternatives considered, support offered, and scheduled review.

Suggested process measure

Sampled difficult decisions with a rationale, impact discussion, and review date / decisions reviewed.

Evidence-informed teaching. Sources: [2]

Kelly Emrick, DHSc, PhD, MBA