Answer for HCA 675 What are the differences you see between a culture of accountability, where people are held accountable for the mistakes they make, and the Just Culture approach, where mistakes are not punished, but seen as methods of learning?  Re: Topic 4 DQ 1

 

The approach of Just Culture in an organization includes “Adopting one model of shared accountability, learning from mistakes vs. blaming individuals, managing behavioral choices (human error, at-risk behavior, reckless behavior), designing safety into all clinical systems and processes, Commitment of organization/leadership to shared goals” (Allyn, 2019, key components of just culture). With this type of culture there is an increase in the number of reporting issues which leads to increased safety, as one is not punished, but looked at as an opportunity for learning to occur (Allyn, 2019). This type of culture allows people to speak up without fear of being reprimanded. When people feel safe to report issues without being reprimanded, they tend not to cover up or hide details associated with error (Allyn, 2019). For some, learning and change may not occur without consequences.

We have adopted the just culture approach in my organization. Since the implementation of the just culture approach, we have seen a huge increase in reporting which has allowed us to provide further education or perhaps a change in the process. Prior to this is was an “us against them” mentality, staff against management, where people would not report, cover-up for other staff when issues occurred. However, this never allowed management to correct the issues through education and process changes. I will also add, it did take some time to make the transition, but as people in the organization began to see that issues brought up were looked at as an opportunity to improve versus punitive, reporting increased so that positive changes through education and process could be made.

The culture of accountability holds people accountable for their actions and mistakes. Culture of accountability can have a positive impact through the production of “organizational success, human fulfillment and the creation of real value” (Partners in Leadership, 2010). “When healthcare organizations hold themselves and their employees accountable, they can learn from mistakes and continuously improve operations. A culture of accountability in healthcare improves doctor-patient trust, reduces the misuse of resources, and helps organizations provide better quality care” (PowerDMS, 2018). However, with the culture of accountability people may not bring forth issues for fear of punishment or the punishment of a co-worker. When issues are not brought forth, they cannot be resolved. The fault may not lie on the person who is assumed to have made the mistake, it may be a process issue or a combination of events that lead to the issue/incident.

References

Allyn, J. (2019). Just culture: balancing accountability with quality and safety. Retrieved from https://www.rsna.org/en/news/2019/February/Just-Culture-Background

Partners in Leadership. (2010). A culture of accountability. Retrieved from https://www.partnersinleadership.com/insights-publications/a-culture-of-accountability/

PowerDMS. (2018). Creating a culture of accountability in healthcare. Retrieved from https://www.powerdms.com/blog/creating-culture-accountability-healthcare/