Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:An Overview of the Culture of Health Care
Lecture:What is meant by "the culture of health care"
Slide content:Just Culture Blame Culture Organizational rigidity Emphasis on compliance with existing practices Fear of punishment Risk avoidance Distrust Silence as the predominant response to error, near misses Just Culture Members believe they can question existing practices, etc. Management openness to worker input Overall commitment to quality Uninhibited reporting of problems Extensive information sharing about problems Organizational response to problem, e.g. staff training, etc. 18
Slide notes:This concept of just culture is more easily understood when contrasted with the blame culture that sometimes exists in organizations and that can interfere with organizational learning and improvement. What we refer to as the blame culture is characterized by a high degree of organizational rigidity and an emphasis on strict compliance with existing practices. The result for members of such organizations is fear of punishment, a tendency to avoid risk, and distrust. The predominant response to an error or near miss becomes silence, because workers are afraid to come forward. Contrast this with the just culture, which is characterized by an organizational learning culture, by an environment in which members believe its okay to question existing practices and where management expresses openness to worker input. Such environments have an overall commitment to quality. Ideally this culture will lead to uninhibited reporting of problems, extensive information sharing about problems, and organizational response that follows up with remediation directed not at removing offending individuals, but on improving processes or execution through staff training and the like. In health care, a just culture means that health care workers believe they are safe to report problems and question practices, and that they are invested in quality improvement. 18