Accountability grids as a structural instrument for role clarity and professional governance in nursing

ABSTRACT: Role ambiguity undermines effective professional governance in nursing, particularly in complex, rapidly evolving health care systems where decision-making authority is distributed. This article introduces accountability grids as structural tools that clearly define ownership, decision rights, contributions, and expected outcomes across nursing roles. Unlike traditional job descriptions, these grids make accountability visible and actionable, reducing confusion, improving coordination, and strengthening trust. By aligning roles with organizational goals and clarifying interdependencies, accountability grids support more consistent decision-making, enhance engagement, and promote sustained excellence in patient care within professional governance frameworks.