Just Culture: What is it?

Chat details

This chat will be held on 06.02.17 8-9pm. We will be using our regular hashtag- #wemhns and a transcript of the chat will be available afterward.

Make sure you put #ebp as well for any evidence based practice articles or projects.

As with all our chats, everyone is welcome to join the conversation. Whether you are a Mental Health Nurse, other Health Care Professional, Academic, Service User, Carer or Citizen with an interest in the subject, we would like to hear your thoughts!

Background

People who access healthcare services need to be safe and experience the highest quality of care. The spirit of ‘just culture’ and ‘duty of candour’ is about improving safety and quality of care for service users and families. We are hoping to gain an insight in to what everyone thinks about a just culture in mental health services and if you have you experienced this.

Previous service improvement approaches may not address underlying culture and leadership concerns and some would say, have tended to focus on overregulation and control with limited staff, service user or family involvement. It is important we create a learning culture through openness and transparency, without poor practice being hidden, with staff feeling comfortable to be open when they make mistakes. All to ensure everyone learns from one another. There is emphasis on joint accountability and responsibility. Service user safety is the most important focus and services need to ensure they do everything they can to promote an environment and a culture that promotes this.

For more information about just cultures and duty of candour, see the useful articles, and please tweet us any you have seen using #wemhns #ebp @wemhnurses

Questions

1) Have you heard about a ‘just culture’ before?

2) What does a ‘just culture’ mean to you?

3) What are your thoughts about a just culture?

4) What do you think some of the positives are of a just culture?

5) What do you think some of the concerns may be?

6) Is duty of candour a fundamental element of a just culture?

7) Does anyone have any good examples/ experiences of cultures that you think have been JUST?

Useful articles and links

Boysen, P. G. (2013). Just Culture: A foundation for balanced accountability and patient safety. The Ochsner Journal, 13(3), 400-406.

Connor, M., Duncombe, D., Barclay, E., Bartel, S., Borden, C., Gross, E., ... & Ponte, P. R. (2007). Creating a fair and just culture: one institution’s path toward organizational change. The Joint Commission Journal on Quality and Patient Safety, 33(10), 617-624. http://www.sciencedirect.com/science/article/pii/S1553725007330717

Dekker, S. W., & Hugh, T. B. (2014). A just culture after Mid Staffordshire. BMJ quality & safety, 23(5), 356-358.

Frank-Cooper, M. (2014). The justice behind a just culture. Nephrology Nursing Journal, 41(1), 87.

Frankel, A. S., Leonard, M. W., & Denham, C. R. (2006). Fair and just culture, team behavior, and leadership engagement: The tools to achieve high reliability. Health services research, 41(4p2), 1690-1709. http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2006.00572.x/full

Hader, R. (2006). A “just culture” proves just right http://journals.lww.com/nursingmanagement/Citation/2006/06000/A__just_culture__proves_just_right.1.aspx Improving service user safety and promoting a shift to do this from a bland culture to a just culture http://www.datix.co.uk/news-and-events/publications/improving-patient-safety-just-culture/

Khatri, N., Brown, G. D., & Hicks, L. L. (2009). From a blame culture to a just culture in health care. Health care management review, 34(4), 312-322.

Lord Francis- Just culture freedom to speak up http://freedomtospeakup.org.uk/wp-content/uploads/2014/07/F2SU_web.pdf

Duty of Candour https://www.nmc.org.uk/standards/guidance/the-professional-duty-of-candour/

Norton, K. (2006). Setting Up New Services in the NHS:‘Just Add Water!'. Jessica Kingsley Publishers.

Pattison, J., & Kline, T. (2015). Facilitating a just and trusting culture. International journal of health care quality assurance, 28(1), 11-26.

Sammer, C. E., Lykens, K., Singh, K. P., Mains, D. A., & Lackan, N. A. (2010). What is patient safety culture? A review of the literature. Journal of Nursing Scholarship, 42(2), 156-165.

Seeking a just culture to design a safer hospital environment. (2005). The Quality Letter For Healthcare Leaders, 17(12), 8. https://www.ncbi.nlm.nih.gov/pubmed/16463953

Thanks to Amy Shaw for putting together the prechat and questions.

Bio

@amy_5haw

Hi I'm Amy Shaw, currently a clinical leader in secure services, enhanced support in the North West region working to improve quality for people with learning disabilities and mental health needs, their families and carers. By back ground I am learning disability trained and have worked in health care since 2005 at which point I changed my career from makeup artistry to support work in learning disability services and then went on to train as a nurse. I have a keen interest in dual diagnosis and improving transparency within organisations to promote service user safety, hence my keenness to chat about a just culture.