Discussion Post Response – A Just Culture In Healthcare

Martin

6 months ago

Discussion Post Response – A Just Culture In Healthcare

Hello,

Yes, I did say that 70 percent of hospitals that have implemented a Just Culture have shown no improvement in the frequency of reported events and non-punitive responses to any errors (Edwards, 2018). This is especially sad because the patient is at the receiving end of such non-compliance. Despite the six key elements of patient care, one of which is safety, where no harm should be done to the patient, hospitals continue to operate in a shroud of ‘deception.’ I say this because when hospital staff refuse to report errors, they put other patients at risk since there is no learning opportunity from the errors made. Further, changes cannot be made to the systems or policies, or whichever may be the case, when errors occur and are not reported. The lack of communication, as you have also cited (Ulrich, 2017), comes from a lack of transparency and trust, a lethal combination when it is expected that ‘Promoting effective care coordination and communication between patients and providers and between providers on behalf of the patients’ needs to be ensured under the six priorities of healthcare provision (Singer et al., 2011).

If I was in charge of helping 70 percent of hospitals, I would shift the focus from a learning perspective to an incentives perspective. When a health practitioner makes an error, the first thing he/she wants to do is to protect their job. Telling such a person that reporting will help others learn does not, in my opinion, seem like something worth risking. However, when a person is given incentives to report any errors, such as recognition for participating in the improvement process following an error, then staff will be more willing to report. When a nurse knows that reporting an error and participating in the implementation of processes/’systems that would prevent future occurrences of the same will also mean getting recognition for it, then such a nurse will most likely report any mistakes.

References

Edwards, M. T. (2018). An assessment of the impact of just culture on quality and safety in US hospitals. American Journal of Medical Quality, 33(5), 502-508.

Singer, S. J., Burgers, J., Friedberg, M., Rosenthal, M. B., Leape, L., & Schneider, E. (2011). Defining and measuring integrated patient care: promoting the next frontier in health care delivery. Medical Care Research and Review, 68(1), 112-127.

Ulrich, B. (2017). Just Culture and Its Impact on a Culture of Safety. Nephrology Nursing Journal, 44(3), 207–259. Retrieved from https://search-ebscohost-com.ezproxy.ccu.edu/login.aspx?direct=true&db=aph&AN=123660932&site=ehost-live

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Question

Discussion Post Response – A Just Culture In Healthcare

RE: A Just Culture In Health Care

I agree with your point on how open communication is a required aspect of any organization that is following a Just Culture. One of the articles I read also emphasized the importance of open communication. It mentioned that “when the trust and transparency that are present in a Just Culture are absent, there is minimal reporting and little discussion of errors and system issues; without reporting and discussion, opportunities to learn and improve are missed” (Ulrich 2017). You mentioned that 70% of hospitals that did not see any improvement, if you were in charge of helping these hospitals, what would be the first step you take towards improving their communication?

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