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Purpose – The aim of this paper is to examine the effects of government reforms to improve the accountability of primary healthcare providers in Scotland. As a result of the reforms, funding arrangements for GP practices changed and new financing mechanisms were introduced; this paper seeks to investigate the impact of these changes. Design/methodology/approach – The investigation is undertaken using a case study method involving a medical practice in Dundee. Interviews were conducted with staff at the practice and one researcher spent a week on site studying documentation and observing procedures. Findings – The main findings from the case study suggest that as a result of the government reforms, new funding allocation procedures for the practice better resemble a system of financial control rather than demonstrating financial accountability. GPs were more willing to engage in discussions regarding new procedures being introduced to demonstrate clinical accountability; they did not anticipate that practice accreditation or professional revalidation would alter their established practices in any way. Research limitations/implications – The main limitation of this research is that it only relates to one case study in Dundee. In addition, further government reforms in this area mean that follow up case studies are needed to see how subsequent changes have addressed the issues raised in the current research; indeed, some longitudinal studies might investigate how cumulative reforms have impacted upon GPs. Orginality/value – Nevertheless, despite these limitations, this paper does build on previous work in this area and provides a platform on which subsequent work can build.

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.

This article aims to describe and analyze the results of efforts to improve patient‐centered care (PCC) in psychiatric healthcare.

Using the methodology of a qualitative case study, the authors studied three Swedish child and adolescent psychiatric care (CAP) units in order to describe how patient‐centered actions are performed. They conducted 62 interviews, made 11 half‐day observations, and shadowed employees for two days.

The article shows that the increased focus on accountability for unit performance and medical risks results in unintended consequences. The patient's medical risk is transformed to a personal risk for the psychiatrist and the resource risk is transformed to a personal risk for the unit manager. Patients become risk objects for both psychiatrists and unit managers, which creates an alignment between them to try to send patients elsewhere. New public management (NPM) reforms may consequently lead to the institutionalization of unintended healthcare practices.

The article shows that accountability pressure to reduce patient risk may create new risks for patients.

The study uses theoretical concepts of risk tradeoffs (risk substitution and risk transformation), which were developed for the macro level, to explain the unintended consequences of NPM reforms at the micro level.

This paper aims to, by looking at the electronic medical record (EMR) from three points of view, bring light to the dynamics that are essential and are currently missing in the USA. The traditional paper medical record has worked for physicians, management and patients since the beginning of practice. Yet the development of the EMR did not begin with all the essential elements of the traditional record that were working, but instead shreds out important aspects of the patient.

Triangulation between three studies – medical, information technology and management studies.

An efficient EMR has to take into consideration more than just one area of study. The dynamics between departments and users of the EMR need an integrated process that includes the necessary pieces of all involved. This hole has not been addressed in academic literature.

The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.

There is a depth, space and volume crucial to the comprehensive nature of medicine. With a perspective or dimension, necessary dialogues can be addressed and more intuitive tacit knowledge from medical expertise can be made available. A prototype, filling the holes of the observed elements in this paper, is possible by using digital objects and including more information than the data of the day. Bringing accountability to the patient, more expertise to the fingertips of the physician and available data for management purposes area are the key ingredients for an effective EMR.

With a comprehensive EMR that works more effectively for those who input the data, the patient’s story can be documented with more detailed efficiency. Filling the holes of the observed elements in this paper all support better healthcare and long-term results for the health of society.

The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.

This paper aims to explore how dispositions of nursing habitus carry shift handover into practice in acute care.

Handover (the exchange of information by nurses between shifts) is more recently purported to be a procedure that transfers the responsibility of and accountability for care to maintain patient safety. Using Bourdieu's theory of practice as lens, this paper examines data from an ethnographic study of nurses' work in acute care to reveal what happens in and around nurses' practices of handover.

Exploring handover as a practice enables identification of nurses' responsibilities of work as professional, clinician and employee. These responsibilities are not practised separately, rather, as braided identities they are embodied into nurses' practices of work. Nurses' clinician and employee identities address the clinical and organisationally relevant material contained in handover, but it is in the ways that nurses embody their responses that their professional identity becomes evident.

Viewing handover as a procedure suggests that nurses are rule followers and/or sole players and conceptualises nurses as individualised professionals only. This received knowledge as doxa misrecognises the centrality of connectedness between nurses in their work in the acute care setting.

Recognising nurses' braided workplace identities as being professional, clinician and employee upends the doxa of nurses work as tasks and roles in the delivery of healthcare in the acute care setting.

Report cards, performance evaluations, and quality assessments continue to penetrate the lexicon of the healthcare sector. The value of report cards is typically couched as enhancing consumerism among patients, increasing accountability among healthcare providers, and more broadly increasing the transparency of healthcare information. This paper discusses the potential benefits and pitfalls of these performance assessments.

This paper briefly reviews empirical evidence regarding the impact of report cards for healthcare providers and synthesizes the role and limitations of these performance measures into distinct evaluation criteria. The rapid proliferation of report cards for healthcare providers suggests a growing need to develop mechanisms and tools to evaluate their impact. The risks associated with utilizing report cards for provider oversight include the deleterious impact on vulnerable populations and a failure to accurately measure quality of care. The capacity to create report cards should not be the sole criterion to develop and utilize report cards to evaluate healthcare providers. Rather, careful consideration of the benefits and risks should accompany the implementation and utilization of report cards into regulatory processes. This report proposes an evaluation checklist by which to assess the role of report cards in a given healthcare context.

This paper aims to understand the impact of emotional labour in specific health care settings and its potential effect on patient care.

Multi‐method qualitative ethnographic study undertaken in a large ICU in Sydney, Australia using observations from patient case studies, ward rounds and family conferences, open ended interviews with medical and nursing clinicians and managers and focus groups with nurses.

Clinician attitudes to death and dying and clinicians' capacity to engage with the human needs of patients influenced how emotional labour was experienced. Negative effects were not formally acknowledged in clinical workplaces and institutional mechanisms to support clinicians did not exist.

The potential effects of clinician attitudes on performance are hypothesised from clinician‐reported data; no evaluation was undertaken of patient care.

Health service providers must openly acknowledge the effect of emotional labour on the care of dying people. By sharing their experiences, multidisciplinary clinicians become aware of the personal, professional and organisational impact of emotional labour as a core element of health care so as to explicitly and practically respond to it.

The effect of care on clinicians, particularly care of dying people, not only affects the wellbeing of clinicians themselves, but also the quality of care that patients receive. The affective aspect of clinical work must be factored in as an essential element of quality and quality improvement.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for “successful” BSC implementation in a NHS multi‐agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, “blind” BSC implementation without consideration of these factors may result in potential “failure”.