Leadership and accountability

This article examines the positive effect that ward managers and directors of nursing with strong leadership skills can have on practice and patient care across an organisation, and argues that competent nurse leaders can prevent systemic failures in care.     

Medical accountability

All patient care aspects of prehospital health care delivery must be physician directed. This process of medical accountability seeks to assure quality EMS patient care. Emphasis in this chapter is on the two main configurations of EMS medical accountability, off-line medical direction and on-line medical control. Topics include EMS physician qualifications, responsibilities, and authority; the role of protocols and standing orders; medical control configurations; and others.     

Professional standards and public accountability

In a rapidly evolving healthcare environment, nurse anesthetists will experience increased pressure to deliver value based anesthesia care. Activities of the professional association must be dedicated to advancing patient safety and excellence in anesthesia. To best serve the public and the profession, the nurse anesthetist profession must continue to be accountable for quality of care to patients, committed to continuing competency for professional practice, and promote sustained communication and dissemination of research-based standards development.     

Consumer participation and social accountability.

Consumer participation in the planning and management of health care programs is prescribed as a method for increasing provider responsiveness to the goals and needs of users of services. However, issues related to the nature of mandates to implement consumer participation has not had the impact on policy development proposed for it. While structural changes can be identified which might enhance the consumer role in decision making, it will also be necessary for the consumer sector to develop a strategy which will prompt major rather than incremental movement.