An assessment of the impact of just culture on quality and safety in US hospitals.

Edwards MT. Am J Med Qual. 2018 Apr 1; [Epub ahead of print].

Just culture is a movement to shift from blame for errors and instead focus on system issuesin order to enhance event reporting and learning from failures. This study examined a survey about just culture in conjunction with Hospital Compare quality ratings and AHRQ's Hospital Survey on Patient Safety Culture. The vast majority of the 270 hospitals that responded to the survey reported adopting just culture. However, respondents reported no improvement in nonpunitive response to error, indicating that a culture of blame persists. The study also found no association between hospital quality ratings and just culture implementation. The author concludes that just culture is not sufficient to create a blame-free culture in hospitals. An Annual Perspective reviewed the context of the no-blame movement and the recent shift toward a framework of a just culture.

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