Just culture principles
Five principles shape the attitudes and beliefs required for a just culture. Creating TRUST is the foundation for committing to a just culture.
Organizations* who make the just culture commitment use these guiding principles to foster a just culture:
Proactively inform healthcare workers about:
- How a person’s actions will be assessed in situations where a patient was harmed or nearly harmed.
- What it means to be held appropriately accountable for one’s actions.
When a healthcare worker is involved in a situation where a patient was harmed or nearly harmed, ensure that:
- Their actions are assessed fairly using a systematic approach that considers those actions in the context of the system and what was happening at the time.
- The impact of bias is minimized when assessing an individual’s actions.
- People are not held accountable for system factors over which they had little or no control.
Two concepts may appear contradictory when assessing a person’s actions:
- Imperfect people – Humans are not perfect and there are many factors that affect the actions that someone takes in any situation.
- Accountability – Healthcare workers are accountable for their actions.
These are reconciled by using a systematic approach to assessing the actions people took in the context of the situation including contributing system factors.
- Peers, managers, and leaders need to support and treat healthcare workers with respect, dignity and compassion when they are involved in a situation in which a patient is harmed or nearly harmed.
Treat healthcare workers with respect and dignity by:
- Not blaming, naming or shaming people who were involved in a situation where a patient was harmed or nearly harmed.
- Engaging healthcare workers in efforts to understand what happened and improve the system.
*Includes healthcare delivery organizations, health profession regulators, and organizations who educate health professionals.