[This article was originally published in Healthcare Quarterly, Volume 9, Number 3.]

"Accountability" is the suitcase word in Canadian healthcare. As policy-makers, managers, researchers and providers, we pack accountability with meaning, carry it around with us and open it up to explain everything from the quality of our relationships with and expectations of one another, to our requirements for more transparency in the use of resources, to our diagnosis of problems and remedies for improving our healthcare system. Despite inconsistencies in the labels we attach to this suitcase and in the ways we use it, we seem to consistently hold it close to us, collectively reinforcing its importance. Strengthening accountability is central to the recommendations made in all recent studies on the future of healthcare, and in subsequent reform efforts at the national level (Romanow 2002; Standing Senate Committee on Social Affairs, Science and Technology 2002) and at provincial/territorial levels (Ontario Health Services Restructuring Commission 2000; Health Canada 2003). Accountability is a common theme in the health policy literature as its penetration in peer-reviewed abstracts and discussion papers continues at an exponential rate. Increasing pressure to demonstrate accountability has prompted this past decade's report card era in healthcare.

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