Grounded accountability in life-and-death high-consequence healthcare settings
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.
Year of publication: |
2021
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Authors: | Flynn, Maureen Alice ; Brennan, Niamh M. |
Published in: |
Journal of Health Organization and Management. - Emerald, ISSN 1477-7266, ZDB-ID 2109532-2. - Vol. 35.2021, 9 (24.08.), p. 228-244
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Publisher: |
Emerald |
Saved in:
Online Resource
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