Just Culture in Healthcare
What is it?
At its core, Just Culture is about transparency, respect, and trust around workplace safety, including issues around bullying, harassment, and discrimination or psychological and emotional safety. The principle has long been applied to workplaces in the aeronautical and military sectors but is relatively new to healthcare.
A workplace that is based in a Just Culture is one that recognizes that, while safety issues are not ideal and may have significant negative impact, everyone must collaborate on a structural or systemic level to address safety matters candidly and transparently, without fear of reprisal.
Just Culture includes:
- Taking steps to avoid and/or reduce safety risks in healthcare organizations
- Promptly dealing with safety breaches or incidences when they do occur
- Fostering a culture of learning, training, and reflection on workplace culture and safety
- Facilitating communication between patients and healthcare workers and healthcare administration around safety issues.
Why Just Culture is Important to Healthcare
While this is evolving, healthcare professions are rooted in a hierarchical structure akin to military, aeronautical, police, and other sectors. As a result, fear of reprisal, reprimand, demotion, embarrassment or other retaliation, makes it difficult to address safety issues or incidences promptly and effectively, leading to a worsening effect over time. Whether it be patient safety or pervasive harassment, bullying, or discrimination, tentative or resistance to report and respond to safety issues, has been proven to significantly undermine workplace safety.
How to Foster a Just Culture in your Healthcare Organization
It starts with a focus on systems within the organizational structure. This is also referred to as, “systems-thinking.” It requires stepping back and evaluating your organizational structure, policies, processes and procedures, funding models, how resources are allocated, and overall governance mechanisms.
Healthcare organizations in Canada are a complex mixture of government policy and funding; unionized workplaces; and, public scrutiny. Accordingly, instituting a Just Culture presents a formidable challenge but it starts with basic training and education and may be applied to different units within the overall healthcare system.
Building out effective Just Culture systems requires a focus on risk-management; Continuous Quality Improvement; and, being a High Reliability Organization.
Risk-Management – this is a well-known term but requires continuous education, training, structure, and process designed to proactively reduce safety risk for both patients, physicians, nurses, and staff.
Continuous Quality Improvement – this refers to a dedicated team approach to improving safety culture; policies, processes, and practice, without fear of reprisal. This relates to both patient and staff safety.
High Reliability Organization – building a high-reliability organization requires an openness to anticipating and confronting the inevitable safety accidents that will occur.
Establishing a Just Culture is critical to protecting both workers and patients in Canadian healthcare organizations, and it starts with understanding and training. Engaging the right professionals to help build out these systems is critical.
Contact us for more information.