Creating a Just Culture: Are you ready?

As a leader, before you begin to create a Just Culture within your organisation, you need to give honest and considered thought to where you and your colleagues believe you are on your journey. Tribe consultant, Colin Hewson, shares how to do this… 

It’s a really positive step to be considering a just, fair and restorative culture of accountability or ‘Just Culture’. 

A Just Culture is a vital feature of a well-developed and mature culture. It creates genuine trust for both leaders and workers that each side will do their part to act safely and react fairly when things go wrong.  

Wherever you are on your Just Culture journey, this isn’t a tick-box exercise or a five-minute fix. In the simplest of terms, you need to demonstrate you care about your colleagues and are civil and respectful in your interactions. 

What are the prerequisites for a Just Culture? 

A Just Culture must always be underpinned by:  

• psychological safety 

• civility 

• engagement.  

Here’s more information on these three areas: 

Psychological safety 

You know psychological safety is present at your organisation when: 

• you believe you won’t be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes 

• you feel part of the team, encouraged to learn, able to share learning and challenge the status quo 

• you feel able to ask questions, admit mistakes, offer ideas and improvements 

• challenging the status quo is not only expected but demanded. 

Civility 

Recognise that, with very few exceptions, people work with good intentions. The negative effect of a lack of civility within the NHS has been researched by Civility Saves Lives : 

• The recipient – average 61% reduction in cognitive ability 

• The bystander – average 20% reduction in cognitive ability and 50% less likely to help others  

• Patients and relatives – 75% reduction in promoters of your organisation 

• The team – overall reduction in cognitive capacity and creativity 

• Outcomes – worse across all significant clinical measures 

Engagement 

A Just Culture can only be created when you talk and listen to workforce conversations. These conversations allow you to: 

• build trust and relationships  

• allow opportunities to give praise and recognition 

• allow learning both personally and for the organisation 

• acknowledge your own fallibility and show you’re human 

• show leadership commitment  

• understand system frailties and why people do what they do. 

The NHS’ Sign Up to Safety campaign summarised a Just Culture as: 

• If you make an error, you are cared for and supported. 

• If you behave in a risky manner by not adhering to policies, you are asked why first before being judged. 

• If you recklessly and intentionally put patients or yourself at risk, you are accountable for your actions. 

 These ideas provide an introduction to creating a Just Culture – a foundational approach to developing a high performing proactive future culture.