Alberta Health Services Just Culture Initiative
Alberta Health Services (AHS) began their journey to develop a just culture in 2014. There are four key aspects of the AHS experience:
- Just culture is a journey. It takes time and effort to continually educate, reinforce, and embed the just culture principles and practices within an organization.
- All organizational policies should support a just culture. AHS uses the just culture guiding principles rather than a policy to ensure this happens.
- To be successful, a just culture initiative needs to be a partnership between the organization’s patient safety, human resources, and operations teams.
- The likelihood of success is greater if the initiative is narrowly focused. Focus the just culture initiative on how healthcare workers are treated when they are involved in a situation where something goes wrong. Just culture impacts and is impacted by many other processes and aspects of organizational culture and quality and safety management including:
- Patient safety incident reporting
- Managing a patient safety incident, including disclosure and apology
- Patient safety incident analysis
- Second victim support
- Patient-focused care
- Psychological safety for staff and patients
Just Culture Guiding Principles document
The guiding principles are applied to all policies that are developed by the organization to ensure they support a just culture.
Just Culture Guiding Principles posters
Seven posters were developed for staff, each highlighting one of the seven just culture principles. There is also a poster about living a just culture with tips for incorporating the principles into everyday actions.
A Fair and Consistent Approach
Creating Trust in the Effective Process
Consideration of the Context and Circumstance
System and Organizational Errors
Leaders are Accountable for Ensuring Improvements
Individuals Will Feel Enabled and Empowered
Individuals Will be Held Appropriately Accountable
Living a Just Culture poster
Just Culture Overview
This is an informational handout for patients, volunteers, leadership, staff and physicians. It provides general information about the just culture initiative and how it relates to the AHS values.
Just Culture Frequently Asked Questions document
This is an informational handout for AHS leaders, managers, staff and volunteers. It provides general information about a just culture in a question and answer format.
When Something Goes Wrong resources
An informational handout and laminated cue card were developed to help people use a just culture approach when something goes wrong. They provide guiding questions that help people use a just culture approach to assessing the situation and the actions of those involved.
AHS uses an embedded expert program to supplement these informational resources. Most of the Human Resources Advisors as well as a group of physician leaders are trained to support managers and peers in applying a just culture approach when something goes wrong.
Appropriate Accountability Decision Support Tool
This tool was developed to help managers apply a just culture approach to their decision-making related to people who are involved in situations where something goes wrong. It encourages those who have to make decisions to consider how the context of the situation influenced the actions that individual(s) took, while minimizing the impact that different kinds of bias can have. Before using this tool information must be collected about the situation, the system factors, and individual factors that may have influenced the actions individuals took.
AHS Appropriate Accountability Decision Support Tool (on AHS website)
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