1. Home
  2. Vol 8, No 4
  3. Ongko

Fostering path to a just culture in healthcare organizations: Influential factors and challenges

Tjindrawati Ongko(1*), Djazuly Chalidyanto(2)
(1) -
(2) Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga
(*) Corresponding Author
DOI : 10.30604/jika.v8i4.2413

Abstract

Patient safety culture is paramount in healthcare, and fostering a just culture is essential for promoting incident reporting as a means of collective learning rather than blame. This study aims to understand the process of establishing a just culture in healthcare organizations, its influencing factors, and associated challenges. Following PRISMA 2020 guidelines, a systematic search of electronic databases from 2019 to 2023 was conducted. The focus was on quantitative, qualitative, and mixed-method studies exploring just culture, patient safety, healthcare organizations, influencing factors, and challenges. STROBE criteria were used for quality assessment, and data extraction included authors, publication year, participants, interventions, and outcomes. To establish a just culture emphasizing accountability and transparency, distinguishing human errors from risky or reckless behaviors is crucial. Building a just culture encourages error reporting while maintaining a balance between a blame-free and punitive environment. Key influencing factors include organizational characteristics (safety climate and just culture) and personal factors (patient safety knowledge), particularly among nurses. The challenges faced include privacy-protecting policies that may hinder open communication and trust factors, as emotional consequences can arise from safety incidents. Fostering a just culture is vital for enhancing patient safety. Five influential factors emerged: Awareness, Empowerment, Organizational Factors, Leadership, and Communication. Challenges include privacy-protecting policies hindering open communication and trust issues, potentially leading to emotional consequences from safety incidents. Further research is needed to explore implementation processes and assess their impact on patient safety culture, incident reporting, system improvements, and responsible behaviors in healthcare organizations

Keywords


fostering just culture; patient safety; healthcare

References


Armstrong, G. (2019). QSEN Safety Competency: The Key Ingredient Is Just Culture. The Journal of Continuing Education in Nursing, 50(10), 444–447. https://doi.org/10.3928/00220124-20190917-05

Barkell, N. P., & Snyder, S. S. (2021). Just culture in healthcare: An integrative review. Nursing Forum, 56(1). https://doi.org/10.1111/nuf.12525

Duffy, W. (2017). Improving Patient Safety by Practicing in a Just Culture. AORN Journal, 106(1), 66–68. https://doi.org/10.1016/j.aorn.2017.05.005

Forster, A. J., Hamilton, S., Hayes, T., & Légaré, R. (2019). Creating a Just Culture: The Ottawa Hospital’s experience. Healthcare Management Forum, 32(5), 266–271. https://doi.org/10.1177/0840470419853303

Gaur, S., Kumar, R., Gillespie, S. M., & Jump, R. L. P. (2022). Integrating Principles of Safety Culture and Just Culture Into Nursing Homes: Lessons From the Pandemic. Journal of the American Medical Directors Association, 23(2), 241–246. https://doi.org/10.1016/j.jamda.2021.12.017

Hays, D., & Kruse, J. A. (2022). Nursing Student and Faculty Perceptions of Just Culture. Journal of Nursing Education, 61(5), 257–260. https://doi.org/10.3928/01484834-20220303-10

Kim, B. B., & Yu, S. (2021). Effects of just culture and empowerment on patient safety activities of hospital nurses. Healthcare (Switzerland), 9(10). https://doi.org/10.3390/healthcare9101324

Monahan, J. J. (2018). Using Good Catches to Promote a Just Culture and Perioperative Patient Safety. AORN Journal, 108(5), 548–552. https://doi.org/10.1002/aorn.12394

Murray, J. S., Clifford, J., Larson, S., Lee, J. K., & Sculli, G. L. (2022). Implementing Just Culture to Improve Patient Safety. Military Medicine. https://doi.org/10.1093/milmed/usac115

Murray, J. S., Lee, J., Larson, S., Range, A., Scott, D., & Clifford, J. (2023). Requirements for implementing a “just culture” within healthcare organisations: an integrative review. In BMJ Open Quality (Vol. 12, Issue 2). https://doi.org/10.1136/bmjoq-2022-002237

Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … McKenzie, J. E. (2021). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, n160. https://doi.org/10.1136/bmj.n160

Rogers, E., Griffin, E., Carnie, W., Melucci, J., & Weber, R. J. (2017). A Just Culture Approach to Managing Medication Errors. Hospital Pharmacy, 52(4), 308–315. https://doi.org/10.1310/hpj5204-308

Small, D., Small, R. M., & Green, A. (2022). Improving safety by developing trust with a just culture. In Nursing Management (Vol. 29, Issue 2). https://doi.org/10.7748/nm.2021.e2030

Tasker, A., Jones, J., & Brake, S. (2023). How effectively has a Just Culture been adopted? A qualitative study to analyse the attitudes and behaviours of clinicians and managers to clinical incident management within an NHS Hospital Trust and identify enablers and barriers to achieving a Just Culture. BMJ Open Quality, 12(1). https://doi.org/10.1136/bmjoq-2022-002049

van Baarle, E., Hartman, L., Rooijakkers, S., Wallenburg, I., Weenink, J.-W., Bal, R., & Widdershoven, G. (2022a). Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Services Research, 22(1), 1035. https://doi.org/10.1186/s12913-022-08418-z

van Baarle, E., Hartman, L., Rooijakkers, S., Wallenburg, I., Weenink, J. W., Bal, R., & Widdershoven, G. (2022b). Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Services Research, 22(1), 1–8. https://doi.org/10.1186/s12913-022-08418-z

Weenink, J.-W., Wallenburg, I., Hartman, L., van Baarle, E., Leistikow, I., Widdershoven, G., & Bal, R. (2022). Role of the regulator in enabling a just culture: a qualitative study in mental health and hospital care. BMJ Open, 12(7), e061321. https://doi.org/10.1136/bmjopen-2022-061321

Yoon, S., & Lee, T. (2022). Factors Influencing Military Nurses’ Reporting of Patient Safety Events in South Korea: A Structural Equation Modeling Approach. Asian Nursing Research, 16(3), 162–169. https://doi.org/https://doi.org/10.1016/j.anr.2022.05.006


Article Statistic

Abstract view : 908 times
PDF (Bahasa Indonesia) views : 1789 times

Dimensions Metrics

How To Cite This :

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.