Exploring health workers' perceptions of accountability within a North West Province public hospital

MBA, North-West University, Potchefstroom Campus, 2017 A recent study by Van Geems, Bester, Middelberg, Du Preez, and Kotzé (2014) explored the supply chain of an antibiotic prescribed to the majority of patients admitted to medical units in South African public hospitals. Through a case study, they concluded that the lack of accountability served as a factor for poor inventory management. Accountability is a complex term. There is ambivalence in literature regarding the meaning of accountability. Accountability within the South African public health sector has also not been extensively explored. When one considers the complexity and multi-dimensionality of the concept accountability, one also should question whether health workers comprehend the meaning of accountability as well as the impact of insufficient accountability within the healthcare sector. This study aims to explore health workers’ perceptions of accountability. This is done by exploring health workers’ perceptions in their own words as well as the unique meanings that they attach to this concept. Although accountability is an abstract concept, the lack of accountability has also been linked to poor patient outcomes. The significance of exploring accountability in public healthcare aligns with current concerns about the poor patient and healthcare outcomes in South African hospitals. The population for the study was health workers employed at a level two public hospital in the Dr Kenneth Kaunda District in the North West province. Through a qualitative, explorative, descriptive and contextual design, health workers’ perceptions of accountability were investigated by means of eight interviews. Health workers refer to sub-categories for instance enrolled nurse auxiliaries, enrolled nurses and healthcare workers. The results obtained in this study, indicated that health workers perceived accountability as one’s responsibilities and tasks while performing one’s job. This refers to responsibilities as set out in the health workers’ scope of practice. In simple terms, to do everything one should as it should be done. However, in practice this is not always the case. As all of the health workers were to an extent able to explain what the results of a lack of accountability is and why accountability is important, especially within their field of employment, there is still a large percentage of health workers who are aware of and knowingly partake in unaccountable practices within the hospital. It is evident that there is a definite contradiction between theory and practice. The perception exists with some of the health workers that once a task is delegated to them, the person who delegated the task should take accountability. Another perception is that if a task is beyond their scope of practice they cannot be held accountable. Regardless of the way in which they performed the delegated task or tasks that are beyond their scope of practice. Very little evidence surfaced from the study to confirm that health workers fully comprehend what the relationship between accountability, patient care and wellbeing is. This leads the study to conclude that there is a definite lack of understanding under health workers about the meaning of and the role that accountability plays within the healthcare sector. Limitations to the study were identified and discussed. The study also provides recommendations to the management of the hospital as well as for future research Masters