Abstract
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.