Collaborative Just Culture: Lessons from the Experts

August 18, 2017 Brigham and Women's Faulkner Hospital

This article was originally published by Brigham and Women's Faulkner Hospital News and is reposted with permission. 

Over the past several years, Brigham and Women’s Faulkner Hospital has introduced the concept of a “Collaborative Just Culture,” which is a system of shared accountability between the hospital and the employees. In a Collaborative Just Culture, organizations are responsible for building safe systems and employees are responsible for the quality of their choices. Simply put, in a Just Culture, staff members feel comfortable speaking up about events, including near miss events. By reporting safety events staff members are able to collaboratively participate in the analysis of these events with a sense of curiosity. Instead of worrying about being blamed, a Just Culture aims to support staff through the event analysis, and encourage them to consider both systems, and personal performance factors that may have contributed. The Just Culture process has been very successful as demonstrated by work in both the Laboratory and the Operating Room.

Now, champions from BWFH are sharing what they’ve learned about Collaborative Just Culture with peers at conferences both nationally and internationally.

At RL Palooza 2017, held in June in Toronto, Patient Safety Project Manager, Tayla Hough and Risk Management, Clinical Compliance and Credentialing Administrative Project Coordinator, Madeline Walsh sat on a panel titled “A Journey Toward Enhancing Safety Culture” where they presented “Enhancing Safety Culture and Safety Reporting Through a Collaborative Just Culture Program.”

“We presented on a panel with two other hospitals,” says Walsh. “It was valuable to see how other institutions are creating a just culture or a culture of safety within their organization. Hearing positive feedback about our Collaborative Just Culture Program solidified all the hard work BWFH staff has put into making this a successful program.”

In addition to sharing BWFH’s best practices, Hough says the conference was a great learning experience. “The week was filled with a wide variety of presentations that demonstrated different takes on how other institutions use RL Solutions to enhance their patient safety and risk management programs to improve the quality of care,” she explains. “Listening to other organizations speak about their efforts was extremely valuable. We are now able to build off some of their own ideas and customize them for our hospital’s needs.”

Director of Risk Management and Compliance, Joanne Locke, has also shared on the topic of Just Culture. At the Northern New England Society for Healthcare Risk Management’s New England Regional Healthcare Risk Management Conference, held in April in Mystic, CT, she presented “Managing the Authority Gradient in a Collaborative Just Culture of Safety.” And she recently visited North Shore Medical Center where she talked about BWFH’s experience creating a Collaborative Just Culture. NSMC is considering how to improve their culture of safety and invited her to speak about how effective the process has been here.

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