Professional Accountability Research Articles

Commentary: Teleconsultation at a tertiary care set-up during COVID-19 lockdown in India.

The current predicament is how to sustain the capacity to provide medical service to the needy while protecting healthcare workers. Telemedicine has clearly outpaced the traditional medical care during this COVID-19 pandemic. Telemedicine is need of the moment to reduce face-to-face encounters at a time when the country is unlocking but the pandemic is persisting. There are 3 modes of communication in telemedicine: video, audio, and texting. 000 care centre should have a set of guidelines for the operator dealing with teleconsultations. An implied consent of the patient is considered as the patient himself registers for teleconsultation. Telemedicine enables “virtual triage” of patients.[1] In case of emergency ocular conditions including trauma, patient can be immediately called in-person to eye casualty. A non-urgent condition might be managed through teleconsultation without compromising patient's health or quality of care.[2] Teleconsultation can also be utilized for reassurance and follow-up of chronic conditions. Use of self-home assessment tests such as Amsler grid is advisable for patients with macular diseases such as Neovascular AMD.[3] These patients can be then followed up through teleconsultation. However, it is the discretion of tele-ophthalmologist to diagnose and prescribe medications, as a teleconsultation warrants similar professional accountability as in-person consultation.[4] It is hence prudent to maintain a central record of patient information, diagnosis, and treatment advised. Consulting ophthalmologist must observe the prevailing institutional norms, protocols, and quality assurance mechanisms in place. Though telemedicine has allowed to decrease the load on medical care, there are still several obstacles to its success. Telemedicine may be immensely useful for adnexal and ocular surface diseases but its role in other sub-specialities such as retina, uvea, and ocular oncology is limited. As a matter of fact, we have observed a trend toward worsening of diabetic retinopathy during the pandemic.[5] Secondly, the accessibility of telemedicine is confined to the upper strata of society. The impoverished strata and the elderly might not be able to access the registration system and tele-consult. Simplifying the process of teleconsultation can increase its accessibility. As the country is gradually unlocking from lockdown, teleconsultation requires a change in guidelines. For example, many routine visits to the eye clinic may be subdivided to reduce in-person contact; A diagnostic in-person visit (biometry, OCT retinal scan) followed by tele-consult to discuss the results. This reduces the number of contacts for clinician and patient and the time spent in clinic waiting areas. The challenge for telemedicine researchers and providers is to acquire the right learning from this experience, ensure the pertinent guardrails are in place, and collect the necessary evidence for building the health system of the future.[6] Though reaching for telemedicine at the current time may be motivated by panic about maintaining a semblance of normalcy during the maelstrom, however in the calmer waters of the future, this practice which we develop now may carry forward.

Utilisation avisée des réseaux sociaux pour la gestion de la e-réputation des médecins internistes français — proposition de recommandations

Social networks (or SoMe) expanded exponentially over the last ten years, including healthcare. SoMe have changed the doctor's daily life and the relationship with patients. Poor management of SoMe can impact on “e-reputation”. On the other hand, the proper use of SoMe allows the opening up of new functionalities in both clinical and research settings. Several scientific societies have made recommendations for the proper handling of SoMe in order to protect the personal information and privacy of physicians. Professionals are advised to differentiate between a professional account and a personal account. Confidentiality settings and certain “codes” for managing publications must be followed. Physicians must be aware that their publications are indelible and can damage their “e-reputation”. The proper handling of SoMe will allow internists to organize their bibliographic monitoring, increase the altmetric of their articles, facilitate communication between researchers and modify the relationship with their patients.

The practice of Primary Nursing. Theoretical framework and experience from the U.S.

Primary Nursing is a delivery system designed for use by a nursing staff in an acute care hospital. The actual practice of Primary Nursing reflects the legacy value of one patient, one nurse. It rests on three foundations: 1) the nurse patient relationship 2) professional accountability and 3/the healing quality of compassion. A key to success of the system is the establishment of a responsibility relationship by the nurse with the patient/family. This unique relationship is the essence professional practice as it facilitates the healing quality of compassion recognized by Hildegard of Bingen, Sister Madeline Clemence Vaillot and others. It also provides a framework for maximum professional accountability. A common source of confusion is staffing issues re. Primary Nursing. Neither more staff nor a different skill are needed because of Primary Nursing. If staff is adequate before Primary Nursing, it will be adequate for Primary Nursing.

Accountability Analysis in the Implementation of Employees Performance in Kanreg II BKN Surabaya

The research aims to analyze administrative and professional accountability in the implementation of employees performance in Kanreg II BKN Surabaya. There are two elements in the implementation of employees performance, namely Employee Work Targets and Work Behavior. Antonio Bar Cendon (1999), states that there are four forms of accountability typology, namely a) Political Accountability b) Administrative Accountability c) Professional Accountability d) Accountability for Democracy. The research uses descriptive qualitative method that focuses on operational principle, internal accountability, external accountability, subject matter, criteria, mechanism, and consequences. Data collection technique is done by observation, interviews, and documentation. The results of the analysis of administrative and professional accountability in implementing employees performance in Kanreg II BKN Surabaya are more dominant type of administrative and professional accountability, that can be seen from the sub-indicator of the dominant type of administrative accountability. The research is inseparable from the supporting factors, namely regulation, supervision, application systems, description of main tasks and functions, rewards, and sanctions.

AI Ethics – Too Principled to Fail?

AI Ethics is now a global topic of discussion in academic and policy circles. At least 84 public-private initiatives have produced statements describing high-level principles, values, and other tenets to guide the ethical development, deployment, and governance of AI. According to recent meta-analyses, AI Ethics has seemingly converged on a set of principles that closely resemble the four classic principles of medical ethics. Despite the initial credibility granted to a principled approach to AI Ethics by the connection to principles in medical ethics, there are reasons to be concerned about its future impact on AI development and governance. Significant differences exist between medicine and AI development that suggest a principled approach in the latter may not enjoy success comparable to the former. Compared to medicine, AI development lacks (1) common aims and fiduciary duties, (2) professional history and norms, (3) proven methods to translate principles into practice, and (4) robust legal and professional accountability mechanisms. These differences suggest we should not yet celebrate consensus around high-level principles that hide deep political and normative disagreement.

Principles alone cannot guarantee ethical AI

AI Ethics is now a global topic of discussion in academic and policy circles. At least 84 public-private initiatives have produced statements describing high-level principles, values, and other tenets to guide the ethical development, deployment, and governance of AI. According to recent meta-analyses, AI Ethics has seemingly converged on a set of principles that closely resemble the four classic principles of medical ethics. Despite the initial credibility granted to a principled approach to AI Ethics by the connection to principles in medical ethics, there are reasons to be concerned about its future impact on AI development and governance. Significant differences exist between medicine and AI development that suggest a principled approach in the latter may not enjoy success comparable to the former. Compared to medicine, AI development lacks (1) common aims and fiduciary duties, (2) professional history and norms, (3) proven methods to translate principles into practice, and (4) robust legal and professional accountability mechanisms. These differences suggest we should not yet celebrate consensus around high-level principles that hide deep political and normative disagreement.

Differences and similarities in scope of practice between registered nurses and nurse specialists in emergency care: an interview study.

Wide variation exists between the nursing competence requirements seen in the emergency care context and the subsequent design of nursing education programmes. Clarifying nursing roles and scope of practice may shed light on inconsistencies and encourage nurses to work to their full potential. Describe and clarify the overarching similarities and differences in registered nurses' and nurse specialists' scope of practice in emergency departments. A qualitative study performed in Finland and Norway, based on 11 interviews analysed by means of qualitative content analysis. The results are presented in three main categories related to nurses' scope of practice: The nurses share the same role, Competence varies and Same accountability and responsibility, with potential for development of the specialist role. Given the varying educational systems that currently exist, management teams face a more or less impossible task if attempting to standardise the scope of practice for different professional nurse groups. Still, nurse specialists possess competence that could be utilised to improve patient care and some specialisations seem more suitable for emergency care than others. Individual skills and qualifications should be recognised, which would enable nurses to work to their full potential. No differences were seen between registered nurses' and nurse specialists' role, and professional accountability and responsibilities in the context studied here, although the level of nursing competence differed. Before and even after consensus on uniform competence standards for the different professional nurse groups is reached, management teams should invest in reviewing nurses' competence in relation to different expertise levels, and strategically recruit so that current health needs in the emergency departments can be met.

The internal/external debate: The tensions within social work supervision

INTRODUCTION: Supervision is crucial to social workers’ practice. Within the current managerial social services environment, the supervisor juggles organisational and professional accountabilities—organisational agendas often dominate practitioners’ reflection. In response, alternative types of supervision have emerged, one of which is external supervision.METHODS: This paper analyses qualitative discussions with key informants and supervisory dyads in community-based child welfare services regarding reflective practices in supervision. Internal and external supervision arrangements were discussed in depth relative to their impact on social work practice.FINDINGS: Analysis of discussions identified four themes: the significance of external supervision for building capacity, resilience and confidential reflective space; the role of internal supervision for managerial and organisational agendas; tensions associated with external supervision regarding funding and accountability; and important attributes of the supervisor in successful working relationships.CONCLUSIONS: External supervision is essential for professional competence but considerable inter-organisational variation exists in how this is utilised. Three key considerations emerged: accountabilities of external supervisor, supervisee and internal supervisor towards collaborative practice, evaluation and feedback; purchasing of external supervision; and the professional development of external supervisors. Further education connecting the importance of the supervisory relationship to realise critical thinking and practice development is essential for the future of social work.

Understanding healthcare provider absenteeism in Kenya: a qualitative analysis

BackgroundHealthcare worker absenteeism is common in resource limited settings and contributes to poor quality of care in maternal and child health service delivery. There is a dearth of qualitative information on the scope, contributing factors, and impact of absenteeism in Kenyan healthcare facilities.MethodsIn-depth semi-structured interviews were conducted between July 2015 and June 2016 with 20 healthcare providers in public and private healthcare facilities in Central and Western Kenya. Interviews were audio-recorded, transcribed, coded, and analyzed using an iterative thematic approach.ResultsHalf of providers reported that absenteeism occurs in both private and public health facilities. Absenteeism was most commonly characterized by providers arriving late or leaving early during scheduled work hours. The practice was attributed to institutional issues including: infrequent supervision, lack of professional consequences, limited accountability, and low wages. In some cases, healthcare workers were frequently absent because they held multiple positions at different health facilities. Provider absences result in increased patient wait times and may deter patients from seeking healthcare in the future.ConclusionThere is a significant need for policies and programs to reduce provider absenteeism in Kenya. Intervention approaches must be cognizant of the contributors to absenteeism which occur at the institutional level.

The Impact of Professional Ethics on Organizational Accountability with Mediating Role of Teamwork

Background and Aim: Given the changing needs of organizations and society, productivity and competition require attention to professional ethics, teamwork and accountability. The purpose of this study was to determine the impact of professional ethics on organizational accountability with mediating role of teamwork. Materials and Methods: In this descriptive-correlational study, the study population was the staff of Ardabil University of Medical Sciences in 2018 According to Cochran formula, 170 people were selected using simple random sampling. Qasemzadeh's Professional ethics (2014), Linchoni's Teamwork (2000) and Bovens's (2005) Public accountability questionnaires were used for data collection. Data were analyzed using SPSS24 and Amos22 statistical softwares. Findings: Professional ethics had a direct and significant effect on teamwork (0.62) and staff accountability (0.58). The direct effect of teamwork on staff accountability was significant (0.43). Also, mediathing role of teamwork in the impact of professional ethics on accountability (0.26) was confirmed. Among the components of professional ethics, empathy (0.95) had the highest and respect for others (0.43) had the lowest factor load. Among the components of teamwork, commitment (0.85) had the highest and the constructive approach (0.49) had the lowest factor load. Among the dimensions of accountability, the dimension of professional accountability (0.90) had the highest and the dimension of legal accountability (0.57) had the lowest factor load. Conclusion: According to the findings, staff training for professional ethics and teamwork skills can provide the ground for unity and teamwork that results in increased organizational accountability. Please cite this article as: Moeinikia M, Kazemi S, Omidvar A, Divband A. The Impact of Professional Ethics on Organizational Accountability with Mediating Role of Teamwork. Bioethics Journal 2019; 9(31): 35-45.

Hospital nurses' professional accountability while using the National Early Warning Score: A qualitative study with a hermeneutic design.

To explore general hospital ward nurses' experiences with the National Early Warning Score and to determine its impacts on their professionalism. The National Early Warning Score has broad appeal; it is a patient safety initiative designed to ensure early identification of and response to deteriorating patients in hospitals. However, it is still unclear how the tool impacts nurses' professionalism. A qualitative study with a hermeneutic design was conducted in autumn 2017; the study consisted of semi-structured, in-depth interviews with 14 hospital nurses. The data were analysed thematically to understand and interpret the nurses' experiences. Methods are reported using COREQ guidelines (see Appendix S1). The study examined nurses' experience with the National Early Warning Score and its perceived impact on their professionalism. Four themes were identified: (a) the National Early Warning Score and clinical judgement in patient assessment, (b) responding to the National Early Warning Score standard, (c) involving the professional community and (d) adjusting the tool. The National Early Warning Score may impact nurses' professionalism in diverse ways. Nurses are aware of the importance of incorporating all of their professional competence, comprising clinical judgement, discretion and accountability, with the National Early Warning Score to accurately assess patients' conditions. Findings indicated that the National Early Warning Score was beneficial to nurses' professional practice; however, accountability to this standard alone does not ensure quality care and patient safety. A greater understanding of the role of nurses' professional accountability when using the National Early Warning Score is needed to improve practice and ensure patient safety.

Zooming in on Institutional Politics: Professional accountability systems as institutional weaponry

In this paper we focus on the development of professional accountability systems as a form of systemic power to enhance institutional control, particularly on the associated institutional politics – the interplay between institutional control and institutional work by different (collective) actors. We address the dialectical nature of these institutional politics and identify three types of power tactics underpinning institutional work: attacking, anticipating and defending. Articulating these power tactics revealed the dialectical flux of power tactics between different parties, and how this in turn arose from and affected the development and strength of (new) systemic power. This shows how gaining institutional control over mostly self-employed professionals (veterinarians) through systemic power without legislation is a more sophisticated process than often assumed based on studies of professionals working in large service firms.

Teaching Staff Professional Ethics and Quality of Educational Output in Federal Universities, South-South Zone of Nigeria

The study examined the extent to which teaching staff professional ethics predict quality of educational output in federal universities, South-South Zone of Nigeria. Four research questions and three hypotheses guided the study. The correlational research design was used for the study. The population comprised 6,305 teaching staff and 32,613 students. Purposive and simple random sampling techniques were used to select 1,275 teaching staff and 3,021 students. Two instruments titled “Teaching Staff Professional Ethics Questionnaire (TSPEQ)”, and a documentary analysis checklist titled “Graduate Educational Output Checklist (GEOC)” were used for data collection. The reliability co-efficient of TSPEQ was determined using the Cronbach Alpha Analysis and a reliability index of 0.83 was obtained. Graph, coefficient of R value and R2 were used to answer the research questions while the f-value of Simple Linear Regression Analysis was used to test the null hypotheses at 0.05 level of significance. The findings of the study revealed that teaching staff professional ethics variables of professional competence, professional integrity and professional accountability significantly predicts quality of educational output in federal universities, South-South Zone of Nigeria. Based on the findings of this study, it is recommended amongst others that, university management should ensure that professional ethics of teacher accountability is upheld by enforcing periodic self- appraisal by teachers, assessment by students and performance appraisal.

A Team Approach to Professional Development and Accountability.

Excellent front-line caregivers are often promoted to supervisory positions because of their abilities, knowledge, and superior communication and critical thinking skills. However, they often lack knowledge of the 5 essential leadership domains. These newly appointed supervisors and managers are eager to learn these new competencies, but their organization is frequently not able to provide this education. Management and leadership skills are often learned on the job. Professional development is left up to the individual. It becomes crucial for upper-management professionals, as stewards of their organization, to ensure that those in first-line and middle management are given the opportunity to develop their skills and advance their careers. In this article, I describe my journey of organizing and developing a self-directed imaging leadership team and the success and professional growth that can be achieved if one remains committed to the goal. This journey paralleled Bruce Tuckman's description of team development. As such, this article is formatted to highlight each of these stages.

PENGARUH DUE PROFESSIONAL CARE DAN AKUNTABILITAS TERHADAP KUALITAS AUDIT

This study was aimed at finding out the effect of due professional care and accountability to audit quality result by auditor specifically in Palembang.The population in this study are entire auditors who registered in public accountant offices specifically in Palembang totally 43 auditor. Sample study is determined with total sampling method, that mean all of 43 auditor become sample. The data resource on this study are primary data. The collecting data method was using questionnaires that distributed to all public accountant offices at Palembang. The data analysis technique used was multiple regression spesifcally due professional care and accountability as independent variable, audit quality as dependent variable.The results showed that due professional care and accountability influenced audit quality partially. This research is concluding that due professional care and accountability influence audit quality simultaneous.

Redefining or reinforcing accountability? An examination of meeting routines in schools

Accountability has been a major feature of educational policy making across the globe, including in the US where there is a persistent focus on student achievement results. This paper examines how accountability influences organizational routines in US schools, paying particular attention to meeting routines. We draw upon in-depth qualitative data gathered in four urban middle schools in which approximately 40 math teachers were engaged in collaboration and data use in order to improve instruction. Over a period of 3 years, we conducted extensive observations of teacher team meetings and interviews with teachers and administrators. An analysis of data reveals that many meetings were dominated by organizational routines that reflected state accountability systems, regardless of whether the topic was assessment, curricular pacing, or planning. At times, teachers and administrators made attempts to shift meeting routines from test-based accountability to a focus on instruction and professional accountability; however, existing routines endured. The findings from this study have important implications for thinking through whether and how the field may move towards more intelligent forms of accountability in the presence of external demands and deeply embedded patterns.

Health workforce governance: Key to the delivery of people-centred care

ABSTRACT Health workforce is an integral part of the health system. Adopting a people-centred approach to health system reforms will depend on the ability to mobilize competent health workers. Governance of the health workforce will be an important consideration. The paper reviews the existing literature to identify current challenges in health workforce governance and provides suggestions on building a people-centred health workforce. Given the intersectoral and interdisciplinary context of the health workforce, governance processes have to challenge the traditional ‘silo’ approach. Efforts have to be directed towards strengthening and forging new partnerships, aligning priorities and galvanizing intersectoral commitment to advance the health workforce agenda. These actions have to be supported by an enabling regulatory environment that breaks down the healthcare silos and augments professional accountability to provide people-centred care.

한국문화예술위원회와 블랙리스트 실행: 관료의 책임성 관점에서

This paper critically explores the blacklisted cases of the Arts Council of Korea from the perspective of accountability theory. Through a literature review on administrative accountability, we divide accountability into professional, political, procedural, hierarchical, and consequential accountabilities. This paper has two objectives: first, to summarize the reason behind the practice of blacklisting in respect to accountability, and second, to evaluate currently discussed innovative agendas of the Arts Council of Korea. Our analysis shows that although the structure, process, and programs of the Arts Council of Korea are designed to encourage its employees to actively exhibit professional accountability, by following the hierarchical action ordered by higher authorities, the practice of blacklisting has been initiated. Second, innovative agendas comprise solutions to enhance both professional and consequential accountabilities; however, through a more critical assessment of these agendas, other ways to supplement professional accountability by improving procedural accountability need to be examined.

Environmental Stewardship in Nursing: Introducing the "WE ACT-PLEASE" Framework.

This article introduces a framework for environmental stewardship in nursing practice, the WE ACT-PLEASE framework. The framework describes five content domains of pollution from health-care sources: Waste, Energy/water, Agriculture/food, Chemicals, and Transportation (WE ACT). It identifies six key professional elements: Professional Obligation, Leadership, Education, Accountability, Science, and Engagement (PLEASE). The framework is positioned within a global context of planetary health and planetary-level environmental harm. The framework image includes directional arrows, pointing nurses toward environmentally safe and healthy practice, decreasing pollution and planetary-level disruptions such as climate change, biodiversity loss, and resource depletion. This framework provides structure and guidance to help nurses decrease harm from practice, meet professional obligations, and create a healthier world.

Navigating Tumultuous Change in the Medical Profession: The Coalition for Physician Accountability.

Collaboration among the national organizations responsible for self-regulation in medicine in the United States is critical, as achieving the quadruple aim of enhancing the patient experience and improving population health while lowering costs and improving the work life of clinicians and staff is becoming more challenging. The leaders of the national organizations responsible for accreditation, assessment, licensure, and certification recognize this and have come together as the Coalition for Physician Accountability. The coalition, which meets twice per year, was created in 2011 as a discursive space for group discussion and action related to advancing health care, promoting professional accountability, and improving the education, training, and assessment of physicians. The coalition offers a useful avenue for members to seek common ground and develop constructive, thoughtful solutions to common challenges. Its members have endorsed consensus statements about current topics relevant to health care regulation, advanced innovation in medical school curricula, encouraged a plan for single graduate medical education accreditation for physicians holding MD and DO degrees, supported interprofessional education, championed opioid epidemic mitigation strategies, and supported initiatives responsive to physician workforce shortages, including the Interstate Medical Licensure Compact, an expedited pathway by which eligible physicians may be licensed to practice in multiple jurisdictions.