Level of Accountability

Accountability can mean different things to different people depending on one’s level of accountability.  Accountability  (n.d.) is the obligation of an individual or organization to account for activities, accept responsibility for them, and disclose the results in a transparent manner. It can include the responsibility for money or other entrusted property. Accountability within an organization is multilayered, with each individual having some form of accountability. Accountability is determined by the organizational structure and the position an individual may hold. Health care organizations must be accountable to the patient.

Accountability in health care can be complicated. The health care organization is accountable to patients, physicians are accountable to patients, and nurses are accountable to patients. Patients can also be held accountable for following orders, by being compliant with medications, and paying for expenses incurred while hospitalized. Accountability is very important in health care, not only because it is multifaceted, but because lives are at stake.

A lack of accountability, including not following policies and procedures, can result in patient death. It is important for health care organizations to have a clear vision, a well-defined mission, and to operate ethically with clear and open lines of communication. Health care organizations work toward creating a culture of accountability, and one way to do this is by holding employees accountable. “When healthcare organizations hold themselves and their employees accountable, they can learn from mistakes and continuously improve operations. A culture of accountability in healthcare improves doctor-patient trust, reduces the misuse of resources, and helps organizations provide better quality care”.

Accountability starts with the organization. The organization is accountable to all employees by providing the necessary resources to meet the goals of the organization, which is providing safe quality care. Organizations are held accountable by the CMS, which puts into place “a payment policy tied to public reporting of quality and safety metrics, accreditation standards and goals for quality and patient-safety performance, and clinical licensure that requires accountability for evidence-based care”. Regulatory bodies hold physicians, nurse leaders, nurses, and all other ancillary departments accountable “in part by licensing caregivers who have the knowledge and skills to understand their role and perform it competently”