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  1. George, Vicki PhD, RN, FAAN
  2. Haag-Heitman, Barb PhD, RN, FAAN, PHCNS-BC


This article introduces an accountability-focused nursing framework to systematically organize and promote quality and safety nursing outcomes. The 4 essential components of this framework include a responsive environment; shared decision making, personal empowerment, and transformational management. These elements promote a professional practice environment that supports clinical nurses to practice at their highest level of autonomy and promotes accountability for patient outcomes. The often-misunderstood concept of peer review is foundational to 2 of the model components.