Essay Example on Just Culture: Requirements and Barriers for Its Application

Just culture is a system that aims at creating a learning culture by designing safety systems and managing behavioral choices. A revision of care delivery systems is done to improve the quality of care and the welfare of the caregivers. This paper looks at the requirements and barriers to the application of just culture in an organization.

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Traditionally, mistakes always result in the automatic punishment of an individual. Individuals are held accountable for any error occurring when caring for patients. This encourages error hiding to avoid punishment and unfair punishment due to the failure of the system(American Nurses Association, 2010). Organizations seeking to prevent the negative effects of this system can employ the just culture. The just culture provides an environment that encourages employees to report mistakes. This creates an environment where causes of an error are easily understood, and system errors are fixed. The just culture assumes that humans will inevitably make mistakes, and therefore it is designed to identify and make system changes to reduce these mistakes.

Organizations applying the just culture use an algorithm for considering what a manager should do when an error is reported.There are three types of errors in a just culture: human error, at-risk behavior, and reckless behavior(American Nurses Association, 2010). Human error occurs when an employee makes a mistake unintentionally. In this case, the individual is considered the second victim and is consoled(CAPA Assurance, 2020). Changesto procedures, training, and design are made. At-risk behavior occurs when there is a behavioral choice that increases the risk when risk is recognized or mistakenly justified(American Nurses Association, 2010). In this case, coaching and removal of incentives for the at-risk behavior while increasing incentives for the right behavior is done. Reckless behavior is the conscious disregard of clear risks or gross misconduct(American Nurses Association, 2010). In the case of reckless behavior, punitive action is taken.

For just culture to occur in the organization, leaders have to strongly support and advocate for the culture among the staff.Supporting staff to implement the changes needed to transition from the previous culture and maintain the culture is essential. For the just culture to occur, nurses should be involved in the organization's decision making; therefore, structures and processes that enable this need to be promoted. Staff needs to work with interdisciplinary partners and control staffing and scheduling. The culture is promoted by the use of new knowledge, encouraging innovations and improvement,establishing a culture of safety and quality care.

There are barriers to establishing a just culture. Changes in the workplace create uncertainty; this may cause staff and leaders to resist change from an old familiar system. When there is a lack of trust between the staff and leaders, a climate of fear develops and makes it hard for the staff to report mistakes even when the culture indicates the error was a human error. The constant system change in just culture can create uncertainty.

Lack of commitment to the just culture by leaders is a massive barrier to the implementation of culture. When leaders fail to take responsibility and involve staff in the process of implementation of the just culture, it is likely to fail. Lack of training and enough time to transition can be a barrier because the new system requires training and time to change old habits, ask questions, and make adjustments.

Conclusion

The just culture aims at determining the root cause of errors and making system changes to reduce these errors. An algorithm is used to deals with the three types of errors defined by the culture. For an organization to effectively apply the just culture, it must make changes and encourage openness and staff empowerment. However, there are barriers to the implementation of the just culture, such as lack of commitment from the leaders and staff.

References

American Nurses Association. (2010). Position statement: Just culture. Washington, DC: American Nurses Association.

CAPA Assurance. (2020, April 13).Just Culture: Evaluating Behavioral Choices. Retrieved from: https://www.youtube.com/watch?v=Q47jOh0nRJ0