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:

Transparently Inform

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.

Respond Appropriately

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.

Understand

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.

Support

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 Respectfully

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.