The concept of accountability in the health care industry stems from the social concept of accountability wherein every single person is held accountable for his/her actions. It is a concept that has helped to maintain societal integrity since without accountability there are no set standards by which a person limits or sets their actions. In the healthcare industry, the concept of accountability has a similar role in that doctors, nurses, and healthcare providers should also be held accountable for their actions. This stems from the fact that these individuals and institutions have the lives of their patients in their hands. What must be understood is that a vast majority of doctors, nurses, and medical institutions are in fact profit oriented wherein their services come at a cost which directly translates into a certain level of income (Beckham, 1997). Without a sufficient level of accountability for their actions, the possibility of medical malpractice, insufficient levels of care, or medical over-billing is a distinct possibility that can occur. In fact, before sufficient levels of ethical standards were implemented in the U.S. healthcare industry doctors often subjected patients to increasingly expensive yet unnecessary tests and examinations to reap greater financial benefits (Beckham, 1997). As such, though patients may trust their lives in the hands of doctors, nurses and medical institutions certain outside accountability measures need to be put in place since at times such trust is betrayed by the very people who are supposed to be saving lives.
Measuring Employee Accountability in the Healthcare Industry
The inherent difference between accountability in the healthcare industry and that of other industries is the fact that in terms of their effect on people healthcare obviously has a more direct and potentially life-threatening effect as compared to other industries (Hendee, 2008). As such accountability in this particular case is held to a much higher standard and measurement since people’s lives are on the line. One of the first methods of measuring employee accountability in the healthcare industry is thus a measurement of performance standards during annual performance reviews conducted by the hospital. This can come in the form of the number of times that particular employee has come in late, the number of complaints voiced against that particular employee within a given year, their participation in operations, the number of patients cared for within the year and the success rate of such patients in terms of getting better both within the hospital and after they have checked out (Hendee, 2008). Performance standards are one of the first measurements of accountability since the degree of dedication placed into doing their job reflects the degree of accountability that person has for the job itself. Various studies examining the connection between employee performance in hospitals and their degree of accountability towards their actions have shown that employees with high rates of performance have equally higher rates of accountability. It must be noted that establishing proper performance standards is one of the steps necessary in measuring employee accountability within a healthcare setting since employees that reach and exceed such goals show that they hold themselves accountable for their actions by reaching the goals set by the institution. Another method of measuring accountability is through regular supervisor feedbacks regarding an employee’s performance (Jenkins, 2006). It is a commonly held belief that not everyone can perform a job perfectly hence the fact supervisors are hired in order to ensure that employees are doing their jobs properly and adjust employees when necessary (Jenkins, 2006). Response to regular supervisor feedbacks regarding employee performance is another method of measuring employee accountability. The reason behind supervisor feedbacks is to help employees know what areas they are lacking in and encourage them to improve in those areas so that they can be more effective with their jobs. An employee’s response to the feedback whether to follow the advice or not do anything at all is a direct measurement of their accountability in doing a job correctly and as such is an indicator of whether a particular employee has a proper sense of accountability towards their actions.
Check and Balances Process
The basis behind a check and balances process is to ensure that one facet of an organization does not become “supreme” in that based on a system of regulation one branch of a particular organization can regulate the other (Kuttner, 1998). The concept of accountability is actually the basis of this particular process since without a system of regulation where one branch can limit the other the possibility of actions without regard to possible accountability is a definite danger that could happen. In the case of a successful organization, a proper checks and balances process will be composed of several departments being limited in their action by another department with each aspect of the process having a certain degree of accountability (Kuttner, 1998). For example in the case of the healthcare industry doctors are held in check by healthcare providers by ensuring that only necessary tests are done to the patient in order to minimize the possibility of extra expenditure. On the other hand, doctors can also hold health insurance providers accountable for specific types of medication, normally not recommended by the insurance provider, that a patient needs based on the insurance plan of the patient and the recommendations of the doctor. In all successful organizations, an important aspect of a successful checks and balances process is to ensure that power is not concentrated onto one particular aspect of the process in order to make sure each aspect of the process itself can be held accountable by another process that can limit its actions.
Accountability and an Organizations Working Culture
Working culture is defined as the set of organizational traits and practices that employees follow within a given business environment. As such their actions, practices, and goals are all determined by the working culture to which they adhere their actions to. What must be understood is that different working cultures promote various types of behaviors within their employees one of them is the idea that they are accountable for their actions (Pennington, 2009). Accountability affects organizations working culture by establishing a set of goals by which employees judge themselves. This can come in the form of reaching set company goals, achieving a certain sales quota or by adhering to a strict moral standard (i.e. those who work in banks. It must be noted that accountability in such cases is the degree by which a person holds himself/herself accountable to meeting those goals set by the organization that is promoted by the working culture of the organization (Pennington, 2009). For example, certain organizations set goals for their employees such as achieving a 1-year accident-free work zone. In his particular case the organization influences the work culture by which they have each employee accountable towards maintaining a set standard of safety. This in turn gets applied to the work culture itself creating an effect wherein maintaining safety becomes an integral aspect by which all employees define themselves by. As such from this particular case it can be seen that accountability affects an organizations working culture by integrating new ideas and concepts which become a new part of the working culture which in turn influences the actions of all employees since accountability towards a particular actions has now become a part of working culture that they adhere themselves to.
Maintaining a Positive Work Culture
In creating a positive work culture what must first be taken into consideration is the fact that it is all to easy to develop a culture of blame wherein no one takes accountability for their own actions and instead blames others for their own faults (Pennington, 2009). One method of resolving such an issue is to base promotion and rewards on performance. Various organizations around the world such as Convergys, Sykes and other relationship management companies focus their attention on developing a positive employee work culture by making sure that employees realize that a reward or promotion is entirely dependent on the level of accountability they take with their own job. The greater the degree of accountability they develop which comes in the form of working harder in order to meet goals to receive promotions or rewards the greater the likelihood that a positive working culture will develop wherein people take in account their own actions rather than assign blame to others.
References
Beckham, J. (1997). The accountability crisis in healthcare. Healthcare Forum Journal, 40(5), 34. Retrieved from EBSCOhost.
Hendee, W. R. (2008). Safety and Accountability in Healthcare From Past to Present. International Journal of Radiation Oncology, Biology, Physics, 71(1), S157-S161
Jenkins, P. (2006). Supervisor accountability and risk management in healthcare settings. Healthcare Counselling & Psychotherapy Journal, 6(1), 6-8.
Kuttner, R. (1998). Must Good HMOs Go Bad The Search for Checks and Balances. New England Journal of Medicine, 338(22), 1635-1639.
Pennington, R. G. (2009). Yes, but how? Nine tips for building a culture focused on results, relationships, and accountability. Industrial & Commercial Training, 41(3), 146-150.