Fair and Just Culture

What does “fair and just culture” mean?

The “fair and just culture” principle that CAPSAC advocates is an approach to medical event reporting that emphasizes learning and accountability over blame and punishment. It is built on the recognition that simply forbidding errors cannot prevent them from occurring. However, by understanding how each error occurred, health care providers can improve safeguards and reduce the chance of future errors.

Will this decrease individual accountability?

It seems counterintuitive that reducing blame would reduce errors, but blame and accountability are not necessarily connected. Adopting a fair and just culture does not mean throwing out an organization’s disciplinary system. Instead, it means changing that system to focus on future error prevention rather than individual punishment.

Does this approach work?

Other safety-conscious industries, such as the airline industry, and health care providers in other states have been able to reduce system problems that lead to errors by adopting the principles of a fair and just culture. When these principles are adopted, health care organizations and providers feel safe reporting more errors and near misses, and this improved reporting improves the odds that system problems are detected and fixed before any real harm can occur.

Why change now?

In recent years, health care providers, consumers, regulators and legislators have become increasingly focused on reducing medical errors. However, there has not been an advocacy organization in place to help all these parties learn about best practices from other systems. Through promoting a fair and just culture in medical event reporting, we can make current efforts to improve patient safety more effective.