Accountability in an Organization
Accountability is important in every organization. This ethical term is often used synonymously with concepts like responsibility, liability, answerability, blameworthiness, enforcement, and other concepts that have to do with expectation of account giving. A simple definition of accountability lies on this statement structure: “A is accountable to B when A is obliged to inform B about A’s (past or future) actions and decisions, to justify them, and to suffer punishment in the case of eventual misconduct” (Emanuel and Emanuel, 1996, p. 229). In leadership and managerial roles, accountability is regarded as the acceptance and assumption of full responsibility for actions, decisions, policies, and products accounted to one individual. In addition, accountability involves the acknowledgment of responsibility for self and contribution as a member of group or team.
Accountability of individuals affects the working culture of an organization in many ways. First, accountability affects the responsibility, liability, performance, and action of every employee. People with low accountability are often neglected and are not included in any sensitive and demanding activities. On the other hand, people with high accountability are often encouraged to join every activity from low demanding to a very complicated activity. Second, accountability affects the process of delegating tasks, duties, and activities to every employee. Employees that are not accountable are often not given tasks to accomplice, duties to carry out, and activities to pursue. (Youngwith, 2007). Third, accountability affects the decision-making process of an organization. Participation and accountability of each employee are important to the advancement or development of one’s career because it “provides [an] opportunity to demonstrate an understanding of the broader issues affecting the company” (Suutari, 2001, p. 14). Fourth, accountability affects the problem-solving process of an organization (Rooney and Hopen, 2004). An organization that employs less accountable workers is likely to fail on solving the encountered and perceived problems of an organization. On the other hand, an organization that employs responsible and accountable individuals is likely to progress because it is likely that such organization will utilize its employees in order to solve the problems within the organization.
To ensure proper accountability in any organization, the system of checks and balances plays an important role because this system allows one branch to test, verify, prove, and limit the activities, actions, and decisions of other branch like in the case of government where there are three branches (executive, judicial, and legislative branches) that provide checks and balances to each other. In a health care organization, patients, medical professionals, and the government employ a system of checks and balance to ensure the responsibility and accountability of each agent that plays important role in the advancement of healthcare system and promotion ad enhancement of individual’s well being.
The Importance of Accountability in Healthcare Organization
In the healthcare system, accountability is very important as dealing with life and health problems of different individuals is very sensitive and complicated. Moreover, the healthcare organization is complex because it involves other organizations and groups which tend to affect the performance and accountability of one another. Before enumerating the importance of accountability in a healthcare organization, one needs to become familiar with the concept associated with it. The concept of accountability in healthcare is comprised of three significant components: the loci of accountability, the domains of accountability, and the procedures of accountability.
The loci of accountability in healthcare comprise the different parties that could be “held accountable or hold others accountable” (Emanuel and Emanuel, 1996, p. 229). This include patients, physicians, healthcare providers (nurses, therapists, and nursing assistants), hospitals, managed care plans, pharmaceutical companies, professional associations, employers, private payers, government, investors and lenders of capital, lawyers, and courts. These parties are held accountable for each other activities particularly the patients, physicians, hospitals, and government parties. Meanwhile the domains of accountability in healthcare involve the activities, practices, or issues for which each party could be held accountable. The six domains in healthcare involve legal and ethical conduct, professional competence, public health promotion, adequacy of access, community benefits, and financial performance. Any party or group of parties is held responsible in carrying out the domains of healthcare. For example, physicians are accountable to promoting the well being of the patients. The government is responsible in ensuring the health of its citizens and on limiting or promoting the duties of physicians. Physicians, patients, and the government could be held accountable to domains in hospitals. Pharmaceutical companies and managed care plans could be held responsible for groups of parties such as patients, physicians, and government.
Meanwhile, the procedure of accountability is comprised of two components: “evaluation of the adherence to or compliance with the criteria for specific content areas and dissemination of the evaluation and responses or justifications by the accountable party or parties” (Emanuel and Emanuel, 1996, p. 230). Evaluation and dissemination of the different domains of accountability in healthcare are important for it encourage development, innovation, refinement, and research. Physicians, hospitals, pharmaceutical companies, government, and managed care plans are evaluated on the risk-adjusted mortality and morbidity of patients. High mortality and morbidity rate encourage problem-solving and decision-making processes that would help reduce mortality and morbidity of patients.
Now that we have identified the different parties, domains, and procedures involved in the accountability in healthcare, we can now proceed to identifying the importance of accountability. First, accountability is important in the healthcare system because the healthcare system deals with matters associated with life, health, and death of a human being. The complexity of the healthcare system requires all parties involved to posses accountability. Each party plays an important role in ensuring the well being of patients and in securing the quality of health of each human being in every community. For example, patients, as well as physicians, pharmaceutical companies, hospitals, and medical institutions are responsible for abiding ethical, efficient, and quality procedures involved in the process of curing disorders or diseases.
Second, accountability in healthcare is important for it encourages trust, cooperation, partnership, team building, and leadership among the involved parties. Entrusting your life to someone you do not know is hard. This is what most patients feel whenever they are into critical situations that require operation and other sensitive treatments. Thus physicians’ and nurses’ accountabilities are important because such ethics would calm patients and would help earn their trust. As for medical teams, accountability of each party is important to ensure cooperation partnership, teambuilding, and leadership toward ensuring the treatment, safety, recovery, wellness, and prevention of diseases.
Third, accountability prevents the culture of blame, inaction, indecision, and failure in the healthcare system. If everyone knows his or her function in the healthcare organization and has the ability to perform it then each component of healthcare system is likely to progress. Being responsible and knowing ones accountability prevents blaming the other party, encourages action and quality decision among everyone, and guarantees success in such organization because accountability provides systematic organization and management of problems, issues, and dilemmas, which are perceived prevalent in the healthcare industry.
Fourth, accountability in healthcare guarantees development, innovation, and progress. When all the parties know their one objective (as for healthcare the objective is to ensure well being) and their responsibility to one another it is likely that they would work together to achieve their goal and provide assurance and security to the other party. This is possible for accountability ensures quality performance and services of each party to avoid being blamed and meeting failures. More to this, knowing each healthcare player’s responsibility saves time, effort, resources, and life, after all, health problem is a matter of life and death (for patients), financial gains and losses (for providers), and trust and service (for government and other medical institutions).
However, not all organizations score high in the manner of accountability especially in healthcare. There are times when physicians blame the patients or the pharmaceutical company for failure in treating certain disease; patients blame physicians, pharmaceutical industry, government, and other institutions for failure to prevent the spread of diseases, and so on. To avoid the culture of blame in healthcare, first, it is important that each organization utilizes a delegation system wherein specialization in the task or job is distributed among individuals or groups (Youngwith, 2007). In hospitals, physicians are delegated the task to provide emergency treatment to patients while nurses are tasked to assist and nurse the patient until his or her recovery from certain disease. Second, healthcare organizations need to employ quality problem-solving process to avoid failure (Rooney and Hopen, 2004). Problems, issues, and dilemmas in healthcare would always exist, thus it is important that any healthcare party knows how to accurately, efficiently, and effectively deal with such matters. It is important that any party utilized scientific method in solving the problems, issues, and dilemmas. Third, the healthcare organization should have a strong decision-making system (Suutari, 2001). Everyone, on their own specialty, could serve as a leader in the decision-making process. A leader, meanwhile, should recognize and acknowledge his or her accountability before proceeding to making a decision. Without these characteristics or components, the healthcare organization (which comprise of different parties) would fail to justify their existence, role, and objective toward the improvement of humanity.
References
Emanuel, E.J. and Emanuel, L.L. (1996). What is accountability in health care?. Annals of Internal Medicine, 124, pp. 229-239.
Rooney, J.J. and Hopen, D. (2004). On the trial to a solution: A seven-part series to improvement your organization’s problem-solving efforts. The Journal for Quality & Participation, 27 (3), pp. 20-24.
Suutari, R. (2001). Playing the decision-making game. CMA Management 75 (7), 14-17.
“The art of decision-making.” (2006). Credit Union Executive Newsletter. November 13, 2006, pp. 7-8.
Youngwith, J. (2007). Delegation dilemmas. Journal of Financial Planning. September-October Issue, pp. 10-12.
