You are currently using an unsupported browser which could affect the appearance and functionality of this website. Please consider upgrading to the latest version or using alternatives such as Mozilla Firefox, Google Chrome or Microsoft Edge.

Restorative just culture

A restorative just culture is one that supports everyone when things go wrong. 

As Sidney Dekker has said, a restorative just culture is about understanding who was hurt, what do they need and whose obligation is it to meet that need.

‘Who was hurt’ is clearly the patient and their families and friends.  It can also ripple out to their neighbours, the community, the people who may be using the same healthcare facility and have lost confidence in the safety of that facility.  ‘Who was hurt’ is also the staff, both directly and indirectly involved.  It too can ripple out across teams, departments and sometimes across organisations.  ‘What do they need’ is about ensuring that everyone’s needs are met in a nuanced and personal way.  One person’s needs may be very different from another’s.  The most crucial aspect following this is to ensure that there are one or more people who are obligated to meet those needs, not just in the immediate aftermath but for as long as required.

It is not a blame free system; it is also not a polarization of people or systems, it is people in systems, people and systems.  When care doesn’t go as planned, or as expected or when things simply go wrong – it is rarely down to individual staff and if it does involve individual staff, it is often because of the system they work in.  Healthcare institutions wherever you are in the world are teeming with the most amazingly skilled and kind individuals who change people’s lives daily.  Highly trained, bright and self-motivated – they just need a helping hand and some really good systems and processes to keep being so. 

At its core the just culture community believes that blame is the enemy of safety.  No matter how much experience you have, no matter how much you have practiced or no matter how much attention you pay there will always be the potential to make a mistake.  A restorative just culture is where individuals can share information openly and freely about their concerns, and are treated fairly when something goes wrong.