Healthcare News & Insights

Create a ‘just culture’ in your hospital & revamp patient care

Having a “just culture” at your hospital encourages open and honest communication among staff when mistakes happen. It can also improve patient safety – and help your facility meet compliance standards. 

The concept of a just culture is designed to move hospitals away from focusing on errors and toward understanding the behavioral choices of employees, according to the research paper “Just Culture: A Foundation for Balanced Accountability and Patient Safety” in The Ochsner Journal.

Establishing a just culture at your hospital requires building awareness, implementing and developing policies that support just culture, and building the tenets of just culture into daily work practices, said the Patient Safety Network (PSN).

The PSN says there are three types of behaviors to be expected at any organization:

  1. Human error – Inadvertently doing something wrong, a slip or lapse
  2. At-risk behavior – Increasing risk where it’s not recognized or where it’s believed to be justified
  3. Reckless behavior – Consciously disregarding a serious and unjustifiable risk

A just culture facility looks at both the individual and the system in place when errors happen, and avoids punishment for simple human error. Instead, punishment is reserved for reckless behavior, and coaching is used for at-risk behavior.

Just culture policies

Policies and processes that punish mistakes without considering the context can make it difficult to create a just culture.

For example, if a policy says a reprimand will be written after three errors, regardless of what those errors are or how they occurred, flexibility and understanding can fall by the wayside in an attempt to assign blame. This breeds negativity and creates a rigid standard for employees. Ultimately, it could do more harm than good.

If an employee makes a mistake due to misreading a medication label, but knew the correct procedure and otherwise followed the right process, giving the person an extreme punishment will lead to a culture of secrecy. Eventually, employees won’t speak up when they make an error, and that can be deadly for patients.

A better option would be working with the employee to determine how to avoid the issue in the future, whether that involves additional training on reading medication labels or color coding certain medications.

Promoting a just culture that allows for feedback without punishment also cuts down on diagnostic errors, which are significant problems for many hospitals.

Want to learn more about creating a just culture in your hospital? Register for the “Just Culture: Create an Environment of Safety & Compliance” webinar here.

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