On the Radar

Notes Balancing the organisational approach is this paper on the need to retain accountability with the individual. Robert Wachter, who has written on this theme previously, reminds us that even while there is virtue in a blame-free approach, there is still an important role for accountability. He discusses relative roles of personal versus institutional accountability, and the degree to which personal accountability may be enforced by outside parties (such as peers, patients, healthcare systems or regulators) versus professionals themselves (‘professionalism’). He suggests that: “In calibrating ‘no blame’ versus accountability, and then further determining the locus of accountability, we should aim for the approach that best answers a series of crucial questions:  Do patients and their representatives feel that professionals— both clinicians and leaders—have attacked medical errors with the seriousness they deserve?  Do individuals in the systems—both clinicians and leaders—feel that they are being treated fairly?  Most importantly, have we made care safer?” DOI http://dx.doi.org/10.1136/bmjqs-2012-001227