Just Culture: The Foundation of Staff Safety in the Perioperative Environment

Abstract

In today’s perioperative setting, staff members are potentially exposed to a variety of safety and environmental concerns. As health care organizations implement measures to provide safe environments for perioperative team members, organizational leaders must pivot away from antiquated mindsets and responses and other hierarchical models of leadership. Foundational to creating and fostering safe environments is providing an atmosphere in which staff members, regardless of their role, are empowered to speak up for safety. This article defines a just culture; explores the critical elements of a just culture, including psychological safety, leader and staff member responsibilities, and staff member empowerment; and provides tools and resources that may be beneficial for leaders who are creating a just culture for staff safety in the perioperative setting.

The relationships between patient safety culture and sentinel events among hospitals in Saudi Arabia: a national descriptive study

“…Examples of interventions that hospitals can implement to improve culture and minimize unpredictable events are implementing effective reporting systems to improve “nonpunitive response to error”, appointing a safety champion for every unit to improve and conduct satisfaction surveys “staffing”, using safety briefings to improve “communication openness”, implementing Situation-Background-Assessment-Recommendation (SBAR) technique to improve “teamwork within units”, and relaying safety reports at shift change to improve “handoffs and transitions” [ 66 ]. Other examples of strategies with leadership responsibility to improve response to error, such as “Just culture”, staff supporting programs, and “good catches” [ 67 ]. “Just culture”, for example, can address two of the weakest domains which are “nonpunitive response to error” and “communication openness”.…”

Errors in medicine: punishment versus learning medical adverse events revisited – expanding the frame

“…Unfortunately, fear of sanctions is the main reason for underreporting [ 8 ]. In an organization with a ‘just culture’, individuals genuinely are eager to learn from events that may represent a safety threat, because there is no wish for assigning blame [ 2 ▪ , 17 , 18 ].…”

Teaching Professional Peer Review With the Use of Simulation

“…As part of recent safety initiatives, a just culture movement has emerged in 79% of acute care hospitals in the United States 8. In organizations that use a just culture, individuals are expected to report errors and demonstrate personal accountability for improving care, and the organization assumes the responsibility for improving system processes 2,5–13. Employees are expected to monitor themselves and each other to ensure safety for all 10,13.…”

“…8 In organizations that use a just culture, individuals are expected to report errors and demonstrate personal accountability for improving care, and the organization assumes the responsibility for improving system processes. 2,[5][6][7][8][9][10][11][12][13] Employees are expected to monitor themselves and each other to ensure safety for all. 10,13 Perinatal care providers and students must be educated about the need for and how to comply with guidelines using a just culture to ensure safety in perinatal care and healthcare for future generations.…”

“…2,[5][6][7][8][9][10][11][12][13] Employees are expected to monitor themselves and each other to ensure safety for all. 10,13 Perinatal care providers and students must be educated about the need for and how to comply with guidelines using a just culture to ensure safety in perinatal care and healthcare for future generations. 14,15 Simulation is a valuable learning strategy that provides the opportunity to practice clinical and communication skills in a safe environment and to receive constructive feedback before performing the skills in clinical practice.…”