The importance of accountability in the health care industry
The core of accountability is answerability, which means bearing the responsibility to answer questions that pertain to the decisions and actions made (Brinkerhoff, 2003, p.11). This constitutes procedures or processes by which one subscribes to and is obliged to provide a justification as one is held responsible for his/her action by another entity who has interest in the actions. Given the nature of the word, two questions arise in the discussion of accountability: 1. what was done, and 2. why was it done. Sanction is another term that is closely linked to accountablity, and this denotes penalties in relation to codes of conduct as prescribed by a certain law or regulation that applies to a specific setting where accountability is being enforced. There are three components containd within the issue of accountability: the loci, or the who, of accountability, the domains of accountability, and the procedures of accountability (Emanuel & Emanuel, 1996, p.230).
In the health care industry, the parties that are held accountable includes the patients, the physicians, the nonphysician health care providers such as nurses and therapists, the hospital, and the government, among others. The concept of accountability has gained massive attention due primarily to the decline in the quality of health care services. As opposed to poor health care services, quality service is defined as the improved chances of achieving the desired health outcomes of individuals in accordance with the current professional knowledge (Glickman et al. 2007). In the issue of poor health care services, hospitals and physicians are primarily being held responsible for their failure to provide positive patient outcomes and ensure security of the patients. There are many things in the medical culture that people in general don’t understand, and this gap puts them in the vulnerable position of being abused. A physician, for instance, may be held accountable for risk-adjusted mortality rates involving a particular disease (Emanuel & Emanuel, 1996, p.230), complications or hospital-acquired infections, screening test rates, or the overall satisfaction of the patient. Thus, the importance of establishing a culture of accountability mainly zeroes in on providing good quality patient care and that patients get the value of money they spent on health care services.
Employee’s accountability in the health care industry
There are several ways to measure an employee’s accountability in the health care industry,and this may include evaluations of routine performance, customer satisfaction measures, assessment or evaluations of their co-employees, and check and balances. Supervisors or managers may implement regular assessment of their team members. At the same time, team members and those members of other teams may also assess the performance of their superiors. The evidence derived from the process and outcome measures acomplished routinely by the management teams involved will provide information of whether or not an employee or a superior is able to perform well their tasks and responsibilities according to the protocols or practices as prescribed by the hospital, the clinical practice guidelines, and/or certain laws or policies on health care. In the same way, customer satisfaction may also be utilized as a reliable measure of an employee’s performance.
Accountability and ethical considerations in leadership and management
There are different stakeholders in the field of industry, and this includes but is not limited to, physicians, patients, hospitals, pharmaceutical companies, the government, and taxpayers. While everyone of them is held accountable for their actions and decisions in the health care setting, healthcare providers hold bigger responsibilities in terms of leadership, and as such, should strive to ensure that efficiency and quality is improved in their institutions. As health care executives, they are faced with various ethical issues that require ethical decisions as well. In order to make sure that the decisions made are all in the best interest of the community, the employees, and the patients, health care leaders should make sure that there is a well-established systematic approach to ethics in the event that an ethical issue arises (Glickman et al. 2007). According to Bueller (2009), while there are many ethical considerations and approaches that health care leaders can take into consideration in establishing a system, there are three under-recognized issues that may also be considered: promoting unrealistic expectations that the health care organization may find too difficult to deliver, rationalizing inappropriate behavior wherein tolerance should be avoided at all times in order to avoid sending mixed messages to the employees, and failing to acknowledge mistakes, which is a very crucial issue in the health care industry as it may entail the loss of lives.
Checks and balances in a succesful organization
Accountability influences the health care industry, or any organization in general, as it serves as an external device for controlling and monitoring the organization’s activities and operations. Similar to the assessment of employees, checks and balances in the health care setting enables the institution to monitor the employee’s performance and provide an appropriate action if there is a reason to believe that an ethical issue is involved. In the same way, checks and balances in any organization serves as a tool that prevents the formation of any harmful relationships within a single department or among all departments as a whole. It also ensures that inappropriate acts, such as those committed against their co-employees, or a misuse of resources, abuse of power, or corruption will be reduced or even eliminated. This can be effectively done by providing a clear definition of each employee’s role in order to easily identify improper behavior and practices within the workplace (Glicman et al, 2007).
Effects of accountability in an organization’s culture
Accountablity generally ensures that employees and other stakeholders in a certain organization is performing well according to the organization’s protocol. With accountability firmly in place and exercised consistently, every employee is enforced to work on completing the duties and responsibilities that come with their roles in the organization. In the same way, the concept of accountability also discourages employees to act inappropriately, both towards their jobs and their co-workers as doing so would result to certain sanctions or punishments that may be imposed on them. When all employees are functioning the way they are expected to, there is a better chance that the organization will accomplish its goals, or improve when it is required or desirable for the good of the company.
Maintaining a positive working culture and avoiding a working culture of blame
For an organization to maintain a positive working culture that is away from the culture of blame, it is important that all employees have a clear understanding of their individual roles and responsibilities, as well as the expectations of the organization from them. This method is a good way of implementing the accountability culture, as well as prevent the culture of blame from developing, as when everyone understands what they are supposed to do, they themselves alone will be held accountable for any mistake committed in terms of their work, inappropriate act, failure to complete their tasks, rendering a low-quality work, and other results which are contrary to their job definition and expectations from them.
Conclusion
The health care industry, like any other organization, will benefit more from applying the concept of accountability and do so seriously. They are dealing with human lives, and there is nothing more serious than that. Apart from being held accountable for their actions and decisions when fulfilling thier duties, accountability is also beneficial for the smooth organization and operation of the health care, as there won’t be any opportunity for a blame culture to develop, and everyone will be encouraged to do better in their own jobs. With the advantages that it brings, it is highly sensible for the health care inustry to adapt the culture of accountability.
References
Brinkerhoff, D. (2003). Accountability and health systems: Overview, framework, and strategies.
Partners for Heralth Reform plus. Retrieved from http://www.who.int/management/partnerships/accountability/AccountabilityHealthSystemsOverview.pdf
Buell, J.M. (2009). Ethics and leadership. Healthcare Management Ethics. Retrieved from
https://www.ache.org/abt_ache/MA09_Ethics.pdf
Emanuel, E.J and Emanuel, L.L. (1996). What is accountability in health care? American
Glickman, S.W, Baggett, K.A, Krubert, C.G, Peterson, E.D. and Schulman, K.A. (2007).
Promoting quality: the health-care organization from a managemet perspective. international Journal for Quality in Health Care pp.341-348. Retrieved from http://intqhc.oxfordjournals.org/content/19/6/341
