Ambiguous accountability: The challenges of identifying and managing patient-related information problems in collaborative patient-care teams

Collaborative patient-care teams rely on accurate and complete information in order to make informed decisions about their patients. However, patient-related information problems (PIPs) are a common occurrence in hospital work. These PIPs are any issues related to patient information that impact the patient-care team's ability to perform their work (e.g., wrong, missing, outdated information). To better understand the challenges that patient-care teams face in identifying and collaboratively managing PIPs related to the use of the electronic health record (EHR), we conducted a qualitative study of patient-care teams during morning rounds. In this paper, we describe the types of PIPs that the team members encountered and how they identified who was accountable for fixing the PIP. Through our analysis, we highlight the challenges that arise when team members have an unclear or conflicting assumption about who is responsible for fixing the PIP. We conclude with a discussion on improving organizational policies and EHR design in order to help reduce ambiguous accountability for the management of PIPs within collaborative teams.