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|Anat Drach-Zahavy and Marina Leonenko|
|University of Haifa, Israel|
|ScientificTracks Abstracts: J Nurs Care|
|Background: Nursing scholars grapple with how to motivate nurses to engage with quality and safe patient care, without strengthening their wellbeing and exit intentions. The answer frequently given to this quandary is to develop, maintain, and strengthen accountability among professionals. Despite the theoreticians’ and practitioners’ emphasis on accountability, empirical research of the concept lags well behind. This study aims to address the gaps in the literature by clarifying the circumstances under which accountability leads to positive or negative outcomes. Aim: The aim of the study was to test the research model, positing that personal and organizational accountability fit will be related to performance, and misfit to exit behaviors. Methods: Participants in the study, which had a cross-sectional nested design, were 148 nurses from 15 nursing units. Personal and Organizational Accountability and exit intentins were measured by validated questionnaires. Performance was assessed by reviewing the medical records of 9 randomly selected patients of each nurse (on different shifts), according to a validated assessment tool. Results: As predicted, the interaction between personal and organizational accountability had an impact on nurses' behavior: (1) Performance scores were highest under the condition of high personal-high organizational accountability. (2) For exit: when organizational accountability was low, the higher the personal accountability, the higher the nurses’ tendency to exit their job. However, when organizational accountability was high, the higher the personal accountability the lower the nurses’ tendency to quit their job. Discussion: The findings support a meso-level integrative model of accountability, which stresses the idea that accountability grows within a context. Personal accountability is not a sufficient predictor of outcomes. On the contrary, the outcomes are critically dependent upon the level of organizational accountability, and only the combination (fit or misfit) of personal and organizational accountability can be distinctively linked to performance and exit.|
Anat Drach-Zahavy is an Associate Professor of Psychology at the Department of Nursing, the University of Haifa, Israel. Her current research focuses on safety issues in the healthcare system. Her studies investigate the context-specific psychological processes that facilitate or hinder the safety of patients and medical staff.
Email: [email protected]
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