Concept Analysis: Just Culture

Abstract

Title: Concept Analysis: Just Culture

Background: Traditionally, healthcare’s culture has held individuals accountable for all errors or mishaps that befall patients under their care. This punitive approach creates the culture of fear among practitioners that withheld information that is needed to identify faulty systems and create safer ones. As an alternative to this traditional system, application of a model which is widely used in aviation industry known as the Just Culture Model seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix the system issues (ANA, 2010).

 

Methods: This concept analysis that utilized the Walker and Avant method aims to (a) observe the basic elements of the concept under study i.e., defining attributes, antecedents, consequences and empirical referents; (b) develop an operational definition that is meaningful across different discipline and participants that can be easily understood and useful across research, policy and practice; and (c) highlight implications for research of the future.

Results: Defining Attributes: According to this analysis, the occurrence of a just culture environment involves three main features which include (a) encouragement of error disclosure through open communication; (b) a well-established balanced accountability; and (c) a collaborative learning environment. These attributes reinforces the implicit claim of just culture that it is inevitable for practitioners to commit mistakes that even the most experienced individual is capable of making mistakes. It is also implied in just culture that punishment is not an assurance that workers will not be making mistakes and that perfecting a performance is impossible and can never be sustained.

Conclusion:    Based on the attributes extracted by this concept analysis, just culture is hereby operationally defined as an environment that reflects a well-established balance accountability supporting collaborative learning that stems from the encouragement of error-disclosure attained through open communication. Having the concept operationally defined and despite the recognized importance of a just culture, not every healthcare institution has adopted this type of approach.

 

Keyword: concept analysis, just culture, nursing practice, nursing education