Importance of Accountability in Nursing

In health care, accountability has become a significant concern. Inside a medical facility, accountability has been a part of people’s every move. Even in financial matters, accountability is also observed. It is also beneficial even on little things such as computing the costs for doctor’s time, medicine, hospital bills, pens and papers, salary of nurses, phone lines and electricity, and even to the toilet paper in the hospital restrooms. Through accountability, an organization will have a risk of overuse, mishandling, and underuse of resources. Hence, it is important for management and legal purposes. It also improves the value of patient care by increasing the use of reliable and approved medicine. In terms of performance, health care workers’ accountability reduces risk of medical malpractice applied to patients. Accountability encourages the employees to look forward to further learning and practice in their field (Brinkerhoff, 2003, p.1). If employees and organizations are aware of their accountability, they are more attentive to their work ethics that protects the organization where they belong as well as the patients.

Measuring accountability helps improving patient outcomes. Reaching the purpose of improving health outcomes needs the hospitals to make progress evaluated by accountability measures. At present times, it shows that such progress occurs at a faster pace. Employee accountability in healthcare has three areas as a basis for measurement. These are performance appraisal, competency management, and learning management (Healthcare Source, 2009, n.p.). When measuring an employee’s accountability through performance appraisal, it notes on the strengths, weaknesses, remarks and earlier performance of an employee. Competency management also measures employees’ accountability as it reviews flexibility and dynamic skills. Lastly, learning management delivers instructional content and evaluates healthcare workers according to their progress. All of these metrics of employee accountability aim to offer quality healthcare to patients.

Ethics, Financial Integrity and Organizational Culture

Accountability and ethics go hand in hand to meet the organization’s mission and vision. However, practicing accountability and ethics by the very people who lead an organization is helpful. Healthcare executives must show the how accountability can positively affect their leadership and management. As these leaders acknowledge their accountability, it reflects into the organization’s culture and soon becomes an ethical practice.

Checks and balances are very useful in every organization. It helps form a truthful organization and creates reliance. It helps avoid fraudulent acts and inaccuracy in computations. Financial integrity is also one of the aims of using checks and balances. If an organization keeps financial integrity, investors and costumers are confident to associate with this organization (Lessing, 2009, pp.1-7). Hence, an organization must keep it to reach success and the checks and balances are common tools that can help.

In an organization, accountability matters. It influences the organization’s working culture by nurturing each employee’s ethical approach to work and helps build a successful organization. If accountability is not present in an organization, its performance is inefficient and idle. When employees as well as leaders practice accountability, their actions form a habit and routine which eventually becomes a culture within an organization (Freund, 2010, pp.32-36). Hence, accountability forms for a long time to form it into an organizational culture. An organization whose culture includes accountability is more likely to reach successful than those who don’t.

Maintaining Positive Working Culture

In an organization, complex problems are usually prone to blaming gaming. Sometimes, the employees’ perception is that, whoever is closest to where a problem arises is the one to blame. This has been a common problem for some organizations. However, to meet success, an organization should keep up a positive working culture. Positive work cultures form for a long time and need continuous attention. There are many ways to avoid the blame game in an organization (Physician Coaching Institute, 2006, n.p.). First of all, each member of an organization including the executives must have awareness of the company’s mission and vision. In times of problems, a leader must not get involved in finger-pointing the culprit. He should set an example among his employees. If an employee is the cause of a problem, constructive comments would help to lessen the risk of facing the same problem again but the flaws on the system have to be eliminated as well. There will be a replacement of the policies that usually hinder the progress of employees with effective and easy ones. Lastly, employees should give their opinion to one another in form of writing or in forum so that they are aware of the things that they are accountable to. Delegation Process

According to National Council of State Boards of Nursing (2012), there are four steps in delegation process of health organizations (pp.1-3).The first step is the assessment and planning, second is communication, third is supervision, and lastly is evaluation and feedback. The assessment stage evaluates the employees who are competent enough to handle a task. Task assignment takes place on this stage. On the communication stage, there will be an exchange of relevant questions between a leader and members. The supervision stage is monitoring the performance of each organization members. Lastly, the evaluation stage will verify if a task is accurately performed and the result is the leader’s feedback. All of these steps play a significant part in the process of delegation. An effective delegation process affects the employees as well as the organization. When there is proper delegation, motivated employees are willing to work harder and contribute their skills which will benefit the organization. A delegation process would also cut the risk of conflict between employees as they are properly assigned of their tasks. Through this process, it is easier to know if a goal is met or not.

As for my personal experience, I have applied similar steps mentioned above when I met a difficulty in a group project where I was an assigned leader. The duties assigned to each member were not properly distributed at the start. What I did was, I began with assessing the skills of my members and planned the tasks they are given. Then, I communicated the results of the first step to the rest of the group members. I supervised their progress all throughout the time of group work. Lastly, I evaluated their outputs and provided feedback for revisions. These steps helped me solve the problem with regards to distribution of tasks.


Brinkerhoff, Derick. (January 2003). Accountability and Health Systems: Overview, Framework, and Strategies. Bethesda, MD: The Partners for Health Reformplus Project, Abt Associates Inc.

Freund,L. (2010).Creating a Culture of Accountability. Retrieved from Healthcare Executive website: >

Healthcare Source (2009).Healthcare Source: Quality Talent, Quality Care. RetrievedFebruary4, 2014, from >

Lessing,J. (2009). The Checks and Balances of Good Corporate Governance.Corporate Governance eJournal,2(16), 2-7. Retrieved from >

National Council of State Boards of Nursing (2012).The Four Steps of the Delegation Process. Retrieved from website: >

Physician Coaching Institute (2006).Working Soltutions for the Blaming Culture – Betty Till, Executive Coach. RetrievedFebruary4, 2014, from >

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