Accountability: A magic bullet for emergency care delays and healthcare access blocks

Abstract

Emergency care delays are one link in a chain of access blocks that permeate our healthcare system. Community patients blocked in hospitals, in-patients blocked in emergency departments, emergent patients blocked in ambulances. The root cause is failure to define, expect, or manage accountability. The easy response to a heavy patient surge is to block access. This protects programs from care demands that would otherwise mandate innovation, and displaces problems to leaders who cannot solve them—a recipe for perpetual dysfunction. Accountability is the evolutionary stressor required to drive system change. The key is a framework defining accountability zones and program expectations. This article focuses on emergency access block, but the proposed solution is relevant across the system.