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The Catalyst

MUSC Medical Center Communications Corner

Just Culture

What is it?
The Just Culture is an approach to dealing with human behavior that balances accountability with the recognition that humans can and will make mistakes. The Just Culture recognizes that we all have “duties” to perform, which can include the duty to follow a rule, the duty to produce an outcome or the duty to avoid harm. If we breach one of our duties, that behavior can be categorized in one of three ways:

  • Human Error: A lapse, a mistake, a slip, an accident.
  • At risk behavior: A behavioral choice that increases a risk, but that risk is either not recognized or is thought to be justified.
  • Reckless behavior: A behavioral choice that increases risk, despite the recognition of the increased risk.

Why does it matter?
Humans have to be held equally accountable for their behavioral choices, across all layers of an organization. The response to the type of behavior should be consistent, and fair:

MUSC Medical Center Communications Corner
  • Human Error: Should be consoled.
  • At risk behavior: Should be coached.
  • Reckless behavior: Should be disciplined.

Who does it affect?
A Just Culture treats everyone the same, regardless of job description, title, or rank. We are all responsible for our behavioral choices.

How will we implement Just Culture?
A dozen Medical University Hospital Authority leaders took a five-day certification course to become proficient in implementing the Just Culture across the organization. The Just Culture four-hour training will be given to all MUHA leaders. Those leaders will then train their staff.

When are we adopting Just Culture at MUSC?
All MUHA leaders will receive a four-hour Just Culture training during a Leadership Development Institute this summer. Those leaders will then train their staff and will adopt the Just Culture at all levels of the organization.

Where can I learn more about Just Culture?
The following website is full of information on Just Culture:

You may also contact any of our Just Culture-certified “academy” leaders for more information:

  • Danielle Scheurer
  • Chris Rees
  • Sheila Scarbrough
  • Deborah O’Donnell
  • David Bundy
  • Helena Bastian
  • Karen Rankine
  • Linda Randazzo
  • Janet Byrne
  • Lisa Langdale
  • Sonja Muckenfuss
  • Debbie Browning

What is the MUSC boat metaphor?
Executive Director/CEO Patrick Cawley, M.D., recently introduced a metaphor relating MUSC to a boat, and you may be wondering what this means or how this metaphor relates to you and your role within our organization.

“The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.”
—William Arthur Ward

Unlike other teamwork metaphors alluding to methods of transportation that require little to no passenger participation, a boat symbolizes unity and working together toward common goals: Keeping the boat afloat and pressing onward.

Regardless of the size and type of vessel you are on, it takes the work of multiple individuals to propel the boat forward. As a large academic medical center, we have many moving parts. Each part is equally as important as the others, and without the collaboration and communication between these various parts, we would not be able to offer our patients and their families high quality care and service.

To drive and steer a boat requires precision, especially when navigating unchartered waters. This symbolizes the need for precision in health care, as well as being able to adapt and adjust when challenges arise in our ever-changing industry.

People and Leadership
Get the right people on the boat
Get the wrong people off the boat
Get the right people in the right positions
Active and engaged

High performance

Complex Environment
Information requiring constant analysis and sharing
Forecasting is vital

May 29, 2013

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