The Indiana Hospital Association and the Indiana Patient Safety Center are working to help Indiana hospitals develop safety supportive practices and culture by launching a statewide “just culture” initative. Just culture—a relatively new concept emerging in health care, has been widely touted by AHRQ and has been used for years in other high-risk industries such as aviation.
The just culture paradigm addresses the weakness of a blame-free approach to errors but also runs counter to an overly-punitive culture. Marx describes it this way:
On one side of the coin, it is about creating a reporting environment where staff can raise their hand when they have seen a risk or made a mistake. It is a culture that rewards reporting and puts a high value on open communication—where risks are openly discussed between managers and staff. It is a culture hungry for knowledge.
On the other side of the coin, it is about having a well-established system of accountability. A Just Culture must recognize that while we as humans are fallible, we do generally have control of our behavioral choices, whether we are an executive, a manager, or a staff member. Just Culture flourishes in an organization that understands the concept of shared accountability—that good system design and good behavioral choices of staff together produce good results. It has to be both."
The just culture statewide improvement plan followed three general stages of development. The first stage was to align leadership of the major participant groups and have them commit to move forward. The second phase was to provide introductory regional education training sessions on just culture concepts to teams of individuals who will implement them within their respective facilities. Finally, institutions will implement the model put forth through the first two stages.
To learn more, visit http://www.justculture.org/
Patient Safety and the "Just Culture": A Primer for Healthcare Executives
Just Culture Community
Patient Safety and the Just Culture- Powerpoint Presentation by David Marx