Accountability and information sharing in hospital shared governance models

Patients are accountable for providing feedback, which is essential for a system of shared accountability to function correctly. Patients may also ask questions, of course and should be expected to follow instructions, because if they do not they are not upholding their part of the arrangement to share responsibility.

After all, shared governance can easily turn into anarchy without intelligible communication between all parties, and this communication is conducted by means of data, information that is gathered and readily interpreted. From this observation, it is easy to see how accountability can be incorporated into a shared governance model, because it can be done by increasing the access to this information -- letting patients, medical providers, payers and personnel "eavesdrop" on the conversation that permits shared governance to work in an orderly fashion, by giving them access (perhaps selectively) to the data that is most relevant to them.

But the sensible and workable nature of such a proposal should be self-evident. After all, if part of the necessity of shared governance comes from the desire to improve patient satisfaction and HCAHPS scores, then it is also necessary to state an obvious fact: patient satisfaction and HCAHPS scores are abstract numerical evaluations; in other words, they are a type of data or "information." And when we view shared governance from the standpoint of an information economy, it becomes clear that the methods by which accountability can be incorporated are actually already tied back to the overall strategy. Accountability is going to hinge on information, and thus some of the central goals of an information economy -- such as the gathering and interpretation of data, and even more importantly the realization that an increase in transparency will improve these efforts -- are going to be part of any viable accountability strategy.

For this reason, it is essential that providers organize information into a coherent and consistent package that patients, personnel and payors can alternately embrace and digest. Simplicity in this process is key and pivotal and information sharing should be smooth and without the kind of headaches that traditionally plague the bureaurcratic relationships of various entities and departments, all trying to compete for the attention of single individuals.

Thus, methods used to incorporate concepts of shared accountability include divesting the structure of any needless distractions and communication should be fluid. Communication is essential, and should be timed and scheduled on a regular basis; for instance when personnel are checking up on payors and coordinating with insurance companies in order to get approval: there must be a formula for follow-up calls and a timeframe that is adhered to so that everyone is kept in the same loop.