Samenvatting

“We agreed to….”: how do health care professionals account for their performance in reports? For many health care professionals, reporting is a daily, necessary task. Reports play a key role in the accountability practice of the care provided, like quality assurance, evaluation, coordination and continuity of health care. However, to write an efficient report in the Electronic Client Dossier (ECD) is not an easy task for professionals. Research illuminates that health care reports do not meet the required quality level, stressing the importance to address writing skills of these professionals. In this study, consisting of 50 health reports of two mental health care organizations, we explore accountability practices of health care providers in reports. The analysis demonstrates how professionals actively give accounts for their performance at two levels, namely (1) the interaction: accounts for the accomplishment of mutual understanding and the unfolding of the institutional conversation and (2) the care content: accounts for the directions of the health care process and/or future steps. These practices of ‘being accountable’ illuminate how the writing process of professionals is embedded in the institutional context of health care. Therefore, to improve the efficiency and quality of reports, it is crucial to train the strategic competence of professionals instead of just training writing skills. Keywords health care reports, accountability, writing skills, interaction, health care professional