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

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.