Peer accountability in patient safety: an under-examined determinant of team performance

Clicks: 18
ID: 328515
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #117 of 164 articles by views in International journal for quality in health care : journal of the International Society for Quality in Health Care

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 164 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Patient safety has been pursued largely through systems, protocols and checklists, yet preventable harm remains common and effective interventions are often difficult to sustain or transfer between settings. A consistent observation is that the same intervention succeeds in one unit and fails in another, the difference lying less in the tool than in how the team functions. This review argues that an under-examined determinant of that difference is peer accountability: the lateral, reciprocal responsibility of team members to uphold shared standards and address departures from them. Distinct from vertical, blame-based accountability and related to but not identical with psychological safety and relational coordination, it is treated here as an integrative facet of team functioning rather than a wholly new construct. METHODS: This is a narrative, non-systematic review. Literature in organisational science, human factors, team sport and patient safety was identified through purposive searching of PubMed, Scopus and Google Scholar up to 2025, with citation tracking; material was selected to develop the central argument rather than to provide exhaustive coverage. RESULTS: Across several fields, the maintenance of shared standards by peers is associated with team performance, illustrated by analogy rather than direct evidence by small-group cohesion research and peer leadership in team sport. In healthcare, the same principle underlies crew resource management, the independent check, speaking-up behaviour and high-reliability organising. Two factors suppress peer accountability: steep authority gradients and a misreading of just culture as the absence of accountability. Acting earlier than disciplinary processes, peer accountability can interrupt the gradual normalisation of unsafe practice, which neither punitive blame nor an undifferentiated no-blame stance prevents. CONCLUSION: Peer accountability complements rather than competes with systems thinking. Any hospital service can strengthen it through small, stable, mutually visible teams; institutionalised independent checking; a reduced gradient for raising concerns; and a just culture that retains individual and shared responsibility. These organisational rather than technological measures require explicit measurement and study before they can be recommended as established practice.
Reference Key
openalex_W7212260899 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Marcos Martínez Sánchez
Are you one of these authors? Claim your profile
Journal International journal for quality in health care : journal of the International Society for Quality in Health Care
Year 2026
DOI
10.1093/intqhc/mzag134
URL
https://doi.org/10.1093/intqhc/mzag134
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.