When infection risk is not fully minimized, this may not always be a systems failure, as I have previously written. I still stand by that. Accountability, for many, is the elephant in the infection prevention room.Accountability, in my opinion, is one of the most critical components of patient safety. It is also one of the most challenging to uphold, particularly as many of us tend to avoid tough feedback conversations with colleagues.
Like data collection and feedback, accountability can also be structured and formalized, as summarized in this report from Johns Hopkins University. This formalized, transparent accountability structure calls for escalating levels of review corresponding to the numbers of months that an entity has missed a performance goal for a measure. Higher level leaders know the goal, know their role, and and ensure that lower level leaders have the skills, resources, time, and feedback (data) to improve. Making performance expectations clear and subject to formalized reviews makes the feedback process more objective, less personal and easier to execute.
Safety works best when it is standardized. Standardization takes effort and oversight. Optionalism is a major barrier to standardization in healthcare.
Structured accountability can halt optionalism.
Time to move forward.
