Grounded accountability in life-and-death high-consequence healthcare settings.
| Autor: | Flynn MA; Health Services Executive, Dublin, Ireland., Brennan NM; University College Dublin, Dublin, Ireland. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of health organization and management [J Health Organ Manag] 2021 Aug 24; Vol. ahead-of-print (ahead-of-print). |
| DOI: | 10.1108/JHOM-03-2021-0116 |
| Abstrakt: | Purpose: The paper examines interviewee insights into accountability for clinical governance in high-consequence, life-and-death hospital settings. The analysis draws on the distinction between formal "imposed accountability" and front-line "felt accountability". From these insights, the paper introduces an emergent concept, "grounded accountability". Design/methodology/approach: Interviews are conducted with 41 clinicians, managers and governors in two large academic hospitals. The authors ask interviewees to recall a critical clinical incident as a focus for elucidating their experiences of and observation on the practice of accountability. Findings: Accountability emerges from the front-line, on-the-ground. Together, clinicians, managers and governors co-construct accountability. Less attention is paid to cost, blame, legal processes or personal reputation. Money and other accountability assumptions in business do not always apply in a hospital setting. Originality/value: The authors propose the concept of co-constructed "grounded accountability" comprising interrelationships between the concept's three constituent themes of front-line staff's felt accountability, along with grounded engagement by managers/governors, supported by a culture of openness. (© Maureen Alice Flynn and Niamh M. Brennan.) |
| Databáze: | MEDLINE |
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