Grounded accountability in life-and-death high-consequence healthcare settings

PurposeThe 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 introdu...

Full description

Saved in:
Bibliographic Details
Published in:Journal of health organization and management 2021, Vol.35 (9), p.228-244
Main Authors: Flynn, Maureen Alice, Brennan, Niamh M
Format: Article
Language:English
Subjects:
Accountability
Blame
Clinical governance
Death & dying
Governors
Health care
Health care management
Hospitals
Interviews
Money
Openness
Patient safety
Research Paper
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:PurposeThe 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/approachInterviews 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.FindingsAccountability 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/valueThe 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.
ISSN:1477-7266
1758-7247
DOI:10.1108/JHOM-03-2021-0116