Assign Accountability

Accountability to patients and families in the face of medical accident is a hallmark of a safety culture. The organization committed to creating a patient safety culture, through its board and its CEO, has in place pohcies, processes, and 

Medical accident, especially when it harms a patient, is a defining moment for an organization. How such an event is managed both expresses and shapes the culture of the organization. When we mean to do well but harm results, we have failed the patient and the patient s family. An accident also affects the care providers at the sharp end, the point of care where technical work is done. It is a devastating event. How the organization responds can reinforce a culture of secrecy and blame, or it can advance a culture of safety, characterized by open disclosure, analysis, learning, prevention, and face-to-face accountability. 

In a safety culture, executive leaders stand shoulder to shoulder with family and caregivers. This means that families are involved in all aspects of the care process and are not left out when accidents occur. The concept of disclosing medical accidents to families is a departure from the comfort zone of many executives and providers, but the greater risk lies in not communicating. Patients and their families are members of the care team and valuable partners in and contributors to creating safety. Participation in care is enhanced by information, truth telling, and disclosure in the care process. 

Data from family focus groups, discussions among staff members, and professional literature were used to develop a disclosure policy at Children s Hospitals and Clinics, Minneapolis/St. Paul, Minnesota. Its creation and content are summarized here. 

The board of directors endorsed a policy of full disclosure to families as part of the overall patient safety agenda. The policy states, Children s Hospitals and 

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Because this assignment accounts for all eight of the Br valence electrons, there are no lone pairs on the central atom and... 

The person who by background or experience has been assigned responsibility and therefore assigned accountability to ensure that the company s safety and health program is adhered to. 

Assign accountability and communicate responsibility for all aspects of the program so that all managers, supervisors, and employees know what performance is expected. 

Define your assigned accountability and responsibility for the safety management system and the sustaining of the safety culture. 

Are assigned accountabilities matched with responsibilities within the leadership... 

Network analysis can be used to determine where and how responsibilities are shifted by assigned accountabilities and authorities. The network may reveal how these are cascading up through the organization. Refer to Chapter 3, Analyzing and Using Your Network . The triad of responsibility, authority, and accountability caimot be separated and must be considered as interrelated and together as a whole. 

Assign accountability for maintenance and repair at the highest levels in the organization. Responsibilities should include effective use of maintenance and repair funds and other actions required to validate prior facility life-cycle cost management decisions. 

Assign accountabilities and responsibilities for risk management functions at appropriate levels within the organization. 

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