Why Accountability Sharing in Health Care Organizational Cultures Means Patients Are Probably Safer

Abstract

Because human errors should be regarded as expected events, health care organizations should routinize processes aimed at human error prevention, limit negative consequences when human errors do occur, and support and educate those who have erred. A just culture perspective suggests that responding punitively to those who err should be reserved for those who have willfully and irremediably caused harm, because punishment creates blame-based workplace cultures that deter error reporting, which makes patients less safe.

National Study of Quality, Safety, and Just Culture in Prelicensure Nursing Education

“…Rather, such threats affect the reporting of errors. The literature supports that a fair and just culture in the workplace reduces errors and increases safety reporting by encouraging the identification of high-risk behaviors and manageable errors (Eng & Schweikard, 2020; Marx, 2001; Penn, 2014; Petschonek et al, 2013).…”

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

“…Changing the culture of a system is challenging and takes time. The actual behaviour of personnel and results to patients can be seen as results of the organizational culture [ 10 ▪ , 11 ]. Especially, values seem to predict behaviour.…”

“…However, on the contrary, there may be concerns that a totally nonpunitive system could open for recklessness because the individual will be immune to disciplinary sanctions, regardless of the actual role in the event. Recklessness as such, is perhaps not so difficult to identify because this is behaviour will not be tolerated in a well functioning safety conscious team [ 11 , 15 , 16 ].…”