Just Culture In Healthcare

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In the past, healthcare facilities have functioned under the premise of isolated work of individuals and when errors occurred, the healthcare provider was at fault and faced reprimand. As time has passed and healthcare has evolved, organizations like the Institute of Medicine (IOM) sought out a stronger culture of quality and safety. They recognized that systemic problems in a healthcare organization can contribute to errors and began to move away from blaming of the individual. This shift brought forth a comprehensive review to look at the events surrounding the errors, identify the true causes, and take appropriate actions (Tocco & Blum, 2013).
In the early 1900’s, the American College of Surgeons attempted to standardize medical education …show more content…
Often hospital administrators were unaware of the problems. Frontline staff members were very knowledge on the issues, but often feared repercussions that had been amplified by the blame culture. The IOM outlined a need to move away from a blame culture in order to understand the complex causes of errors. This new way of thinking was referred to as a Just Culture that worked to analyze actions of clinicians involved in errors to recognize the contribution of systemic factors (Tocco & Blum, 2013). The key to a Just Culture is justice and a fair, methodical risk-reduction strategy for examining the way errors, near misses, and system flaws are reported in order to make a positive change (Frank-Cooper, …show more content…
Improvement does not necessarily mean that there is a flaw but that there might be a better way of doing something. One of the most effective models of improvement is the Plan-Do-Study-Act (PDSA) cycle which tests changes to assess if they lead to improvement. The PDSA cycle is a shorthand for testing a change by planning it, trying it, observing the results, and acting on what is learned. It is part of the IHI Model for Improvement. The cycle asks: What are we trying to accomplish, what is the aim? Then questions how we will know that a change is an improvement? And third, what changes can we make that will result in improvement. Once these questions are answered, clarity is revealed and planning the improvement can begin. The next step is to test or study the results. The PDSA cycle is a scientific method used for action-oriented learning (Plan-Do-Study-Act (PDSA) Cycle, n.d.). PDSA cycles of testing are applied repeatedly with each new testing cycle building on what was learned from the previous one. Testing often starts on a small scale and is repeated until desired results are achieved. Then testing is spread to a larger group until the new process is implemented for the benefit of all. The improvement team is only able to make changes to the process if they have the information. That data can only be expanded by testing and
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