Principles of a fair and just culture include (select all that apply):

Question

a. zero tolerance for reckless behavior.
b. reduction of personal accountability and discipline.
c. recognition that competent professionals make mistakes.
d. errors and unintended events being re-ported unless no patient harm occurs.
e. acknowledgment that even competent professionals develop unhealthy norms.

Answer 1

A, C, E
In a fair and just culture, everyone throughout the organization is aware that medical errors are inevitable, but all errors and unintended events are reported—even when the events may not cause patient injury. This culture can make the system safer as it recognizes that competent pro-fessionals make mistakes and acknowledges that even competent professionals develop unheal-thy norms (shortcuts or routine rule violations), but it has zero tolerance for reckless behavior. Three principles of a just culture can be stated as follows: 1) A fair and just culture is not an ef-fort to reduce personal accountability and discipline. It is a way to emphasize the importance of learning from mistakes and near misses in order to reduce errors in the future. 2) In a fair and just culture, an individual is accountable to the system, and the greatest error is to not report a mis-take and thereby prevent the system and others from learning. Policies that would discourage any health care provider from self-reporting errors are therefore at odds with the goals of a fair and just culture. 3) A new culture of patient safety is successfully created when all serve as safety advocates regardless of their positions within an organization. Providers and consumers will feel safe and supported when they report medical errors or near misses and voice concerns about pa-tient safety (Marx, 2007).