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Accountability in the Health Care Industry

#Sample College Research Paper

Accountability has become the operational term for serious organizations. With increasing access to information engendered by greater developments in communication technology, more consumers are raising their bar on accountability standards for organizations. Similarly, organizations are rising to this challenge by developing strategies to ensure they remain accountable to their valued clients. Meanwhile, there are legal regulations and standards of accountability specially defined for every industry.

Benefits of accountability

Emmanuel and Emmanuel (1996) define accountability as the systems and structures by which people or organizations justify and own up to their actions. In the health care, accountability entails ensuring quality services are rendered to patients and employees and that malpractices are avoided at all costs. Accountability in the health care has political, financial and performance implications. Political ramifications have to do with the health care business reputation. A suit from a patient complaining of malpractice in a hospital can greatly reduce the likelihood of potential clients choosing the facility in future. By maintaining high standards of accountability, hospitals will also forego the financial implications of liability and blame for malpractice. Lastly, accountability enables a health care facility to focus on performance. By not worrying about the possibility of errors and malpractices, care givers will focus on strengthening service quality and customer relations.

Measuring employee accountability

Organizational accountability is a product of employee accountability. A person is said to be accountable if he or she is able to identify, take responsibility and seek acceptable action for their own mistakes (Lowe, 2013). The accountability cycle seeks to maintain a balance of mutually beneficial relationships. To measure employee accountability, health care facilities have to put in place systems to respond to potential risks and sensitize employees about them.

Health care organizations must also foster internal ethical cultures or standards. Employees need to fully understand what is expected of them. They must also be fully equipped to deliver expected results. They must be equally motivated to undertake their duties. When they encounter difficulties, it is expected that employees will freely communicate these challenges to the relevant authorities. Accountability is, therefore, measured by how much employees commit themselves to honest pursuit of expected outcomes based on the above expectations.

Accountability and ethical considerations in leadership and management

Leaders and managers are expected to be the models of accountability for their employees and other stakeholders. It becomes easier for leaders to enforce ethical standards when they themselves practice those standards. Therefore, accountability in health care basically entails living up to ethical standards of health care practice and profession.

Ethical decisions in leadership and management appeal to the leader’s moral integrity. In the context of health, for example, a leader may be trying to decide whether or not to take drastic action against a malpractice that has been brought to his attention. In their decisions, managers must instill in employees a spirit of personal discipline and responsibility. This will make it easy for responsible staff to be singled out and action taken in case of mistakes. It is the only way that an organization will be able to uphold its ethical culture as part of its image to the clients (Porter-O’Grady & Malloch, 2007).

Checks-and-balances process in a successful organization

Checks and balances are the measures put in place to help identify and communicate anomalies in a system or process. In a health care setting, checks and balances define who is answerable for which processes and sections. When a doctor comes in to ask for drugs, the pharmacist is expected to keep a clear record of the doctor and the nature of drugs taken and time. If those drugs are misplaced or misappropriated, it will be easy to follow the line of movement. Therefore, proper documentation of the use of organizational resources helps to provide checks and balances against unethical practices.

In respect to decisions, checks and balances also define the levels of authority. Responsibility is assigned to the person with the highest level of authority in a given section. Under such a person, the duties and responsibilities are clearly defined for every staff member. It must be made clear who is answerable to whom. Heads of sections make decisions which are then taken by those in higher authority as recommendations for action. The top leadership then makes the ultimate decision on the course of action to take. This helps to streamline accountability for decisions across the entire organization.    

Effect of accountability on organizational working culture

Accountability and organizational working culture should not be two separate concepts. Rather, accountability should be fused within the working culture. When accountability is treated as a separate entity, asking employees to show accountability becomes difficult. Employees need to see accountability as how the organization “does what it does.”

As already mentioned, accountability reduces costs to be incurred by an organization for reparation due to unethical conduct. A culture of accountability, therefore, enhances employee commitment to efficiency and quality results from work (O’Hagan & Persaud, 2009). Accountability also enhances performance. This is because in a culture of accountability, employees do not need to focus on the ramifications of their misconduct. The management also saves time often wasted trying to repair damages caused by unethical work practices. Instead, all the energies and resources of the organization are directed at realizing results.

Health care facilities need to infuse a culture of accountability within their strategies to promote work output, quality and efficiency. The culture of accountability begins with the top leadership. The leadership must demonstrate that hard work and integrity are inseparable. Secondly, patient safety and other measures of quality care should clearly define the element of accountability within hospitals. It should also be made clear that performance is not just a product of the quantity of work output but also the level of accountability exhibited by an employee.  

Maintaining a positive working culture and avoiding a working culture of blame

Often, accountability is understood negatively as defining who is to blame for wrongs done in an organization. This view has made accountability a less popular concept among employees. It also makes employees rush in to find who to blame whenever there is a crisis in the organization. It is important that management ensures that every employee understands what is meant by accountability. They should be helped to understand that accountability is part of general personal and work ethics.

Secondly, the leadership must demonstrate accountability in their own work. When there is a crisis, leaders should not be seen apportioning blame instead of taking responsibility. Sullivan and Decker (2009) suggest that a proper definition of duties and responsibilities can enhance accountability. Leaders also need to make accountability an essential part of organizational team spirit. In this way, rather than assign blame among themselves, employees will feel that the entire organization is responsible for unlikely occurrences.

Accountability is an age-old practice. It has been given greater emphasis in recent organizational management and practice. This work has discussed accountability as an aspect of health care professional practice. Due to the nature of its services, health care facilities are required to demonstrate the highest forms of responsibility and accountability.

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Emmanuel, E. J., & Emmanuel, E. L. (1996). What is accountability in health care. Ann Intern Med., 15(2), 229-239.

Lowe, N. K. (2013). Leadership, Accountability, and Safety in Health Care. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 42(3), 247-248. 

Porter-O’Grady, T., & Malloch, K. (2007). Managing for success in health care. St. Louis, MO: Mosby.

Sullivan, E. J., & Decker, P. J. (2009). Effective leadership and management in nursing (7th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

O’Hagan, J., & Persaud, D. (2009, April/June). Creating a culture of accountability in health care. The Health Care Manager, 28(2), 124-133.

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