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The purpose of this paper is to examine the perceived Bangladesh privatized healthcare sector accountability gap.

Data were collected from 533 patients using services in 45 Dhaka city privatized hospitals. A questionnaire was designed based on 60 patient focus study group and the literature.

Structural equation modeling provides a comprehensive picture that allows healthcare constructs and accountability to be tested. The goodness‐of‐fit statistics supported the four factors of professionals, administration and management, legal enforcement, ethics and government, which were significantly associated with accountability. Despite Bangladeshi privatized healthcare growth, the study revealed that accountability mainly depends on government initiatives and effectively implementing existing laws.

The study covered one Bangladesh city (Dhaka) owing to resource constraints. Qualitative methods may have enriched the findings.

The accountability dimensions may be applicable to other countries to examine the perceived accountability gap. The study looked at the current Bangladesh privatized healthcare sector. Major issues of Bangladesh privatized healthcare accountability are discussed and recommendations for policymakers are suggested to improve the current circumstances.

The study is the first of its kind to examine accountability among privatized healthcare providers in developing countries. Patients’ accountability views require urgent attention from policy makers.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Accountability within distributed leadership (DL) is critical for DL to drive positive outcomes in health services organizations. Despite this, how accountability emerges in DL is less clear. This study aims to understand how accountability emerges in DL so that distributed leaders can drive improvements in healthcare access – an increasingly important outcome in today’s health services environment.

The authors use an instrumental case study of a dental institution in the USA, “Environ,” as it underwent a strategic change to improve healthcare access to rural populations. The authors focused on DL occurring within the strategic change and collected interview, observation and archival data.

The findings demonstrate accountability in DL emerged as shared accountability and has three elements: personal ownership, agentic actions and a shared belief system. Each of these was necessary for DL to advance the strategic change for improved healthcare access.

Top managers should be cognizant of the emergence processes driven by DL. This includes enabling pockets of employees to connect, align and link up so that ideas, processes and practices can emerge and allow for shared accountability in DL.

The overarching contribution of this research is identifying shared accountability in DL and its three elements: personal ownership, agentic actions and a shared belief system. These elements serve as a platform to demonstrate “how DL works” in a healthcare organization.

The purpose of this paper is to synthesize insights from previous accounting, performance measurement (PM) and accountability research into the rapidly emerging field of knowledge-intensive public organizations (KIPOs). In so doing, it draws upon insights from previous literature and other papers included in this special issue of Accounting, Auditing and Accountability Journal.

The paper reviews academic analysis and insights provided in the academic literature on accounting, PM and accountability changes in KIPOs, such as universities and healthcare organizations, and paves the way for future research in this area.

The literature review shows that a growing number of studies are focusing on the hybridization of different KIPOs, not only in terms of accounting tools (e.g. performance indicators, budgeting and reporting) but also in relation to individual actors (e.g. professionals and managers) that may have divergent values and thus act according to multiple logics. It highlights many areas in which further robust academic research is needed to guide developments of hybrid organizations in policy and practice.

This paper provides academics, regulators and decision makers with relevant insights into issues and aspects of accounting, PM and accountability in hybrid organizations that need further theoretical development and empirical evidence to help inform improvements in policy and practice.

The paper provides the growing number of academic researchers in this emerging area with a literature review and agenda upon which they can build their research.

U.S. hospitals face calls for accountability from regulators, professionals, academics and consumers. Transparency and wider dissemination in reporting of financial performance is an integral component of accountability. This paper investigates the extent to which U.S. hospitals have used the Internet to disseminate financial information and demonstrate accountability to the communities they purport to serve. The authors examine the availability of financial information on the websites of the American Hospital Association’s 100 Most Wired healthcare systems. Results of this investigation indicate that the vast majority of the most technically competent U.S. hospitals have yet to embrace the Internet as a tool for financial disclosure. The findings highlight a lack of transparency and an accountability gap for U.S. healthcare systems.

The paper examines interviewee insights into accountability for clinical governance in high-consequence, life-and-death hospital settings. The analysis draws on the distinction between formal “imposed accountability” and front-line “felt accountability”. From these insights, the paper introduces an emergent concept, “grounded accountability”.

Interviews are conducted with 41 clinicians, managers and governors in two large academic hospitals. The authors ask interviewees to recall a critical clinical incident as a focus for elucidating their experiences of and observation on the practice of accountability.

Accountability emerges from the front-line, on-the-ground. Together, clinicians, managers and governors co-construct accountability. Less attention is paid to cost, blame, legal processes or personal reputation. Money and other accountability assumptions in business do not always apply in a hospital setting.

The authors propose the concept of co-constructed “grounded accountability” comprising interrelationships between the concept’s three constituent themes of front-line staff’s felt accountability, along with grounded engagement by managers/governors, supported by a culture of openness.

The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.

This paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations.

This research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors.

Policymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare.

This paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.