Just Culture Network

There is no national agreed definition of ‘just culture’. Our definition of Just Culture is evolving but has been co-produced with people with lived experience of being impacted by a patient safety incident. We feel our definition is a more inclusive and holistic definition of Just Culture as it considers the need for support for not only healthcare employees but also patients and their families and carers:

‘To have confidence as a member of staff or a patient that when things go wrong, support for everyone will be the primary goal and that learning for improvement will be pursued with openness and transparency. ‘ (Yorkshire and Humber Patient Safety Translational Research Centre (PSTRC) 2021)

A Just Culture Network aims to:

• Develop the understanding of the impact of organisational Just Culture on patient safety
• Facilitate effective dissemination of research, good practice and thought leadership related to how healthcare organisations support staff, patients and their families and carers involved in patient safety incidents
• Assist organisational leaders and managers to better understand what they could do differently to better support ALL those involved in and impacted by a patient safety incident
• Create a safe space for network members to openly discuss issues and identify opportunities for partnership working within and across organisations to overcome these issues at the organisational and system level
• Generate learning and action to improve local systems, drawing on insights, expertise and shared learning from fellow network members.

Just Culture Assessment Framework

The identification by A Just Culture Network members of the need for more support to identify the most effective ways of implementing change to achieve a more ‘Just Culture’ led us to work with the Yorkshire and Humber PSTRC to develop a Just Culture Assessment Framework (JCAF) to support organisations in measuring and improving their organisational culture. The JCAF is adapted from Dekker (2012), the NHS Patient Safety Incident Response Framework (2020) and other research evidence in this area, in particular the ‘Just Culture’ measure developed by Petschonek et al (2013)

The illustration above shows the four key domains within the JCAF. Linked to each domain are several standards which organisations can assess themselves against and use to identify areas for improvement which if action would lead to improvements in organisational Just Culture. ‘The fuller version of the image which includes all the individual standards and how they map into the four domains can be viewed by clicking on the image above.

The Framework is being piloted by members of the A Just Culture Network and as such, the content may be further revised on the back of learning from it’s implementation.

We are asking for your support to:

1. Encourage NHS organisations to assess themselves against the principles and behaviours associated with a more Just Culture and act to continuously improve.

2. Emphasise the need for compassionate and collective leadership to ensure healthcare employees are supported to recover, learn and act following their involvement in patient safety incidents.

3. Encourage NHS organisations to use a holistic approach when learning from patient safety incidents. This should consider the needs of patients, their families and the healthcare employee(s) involved.