Moving to a Just Culture in Health Care: Balancing Punitive and Blame Free Cultures to Support Safe, Accountable Care

Michelle Freeman, RN; MSN
Faculty of Nursing, University of Windsor
Windsor, ON


This paper will discuss the current tension in the health care environment regarding whether nurses should be disciplined for errors made during the delivery of patient care. It is now understood that most errors result from faulty care delivery systems, not faulty practitioners. But what should be done with individuals who ignore safe practices? Should these behaviours be tolerated even though we know they place our patients at potential risk?

This paper will describe a framework to assist leaders with decision making on when to console, to coach or to discipline. It can be applied in health care and education environments. Case studies will be used to allow the audience to apply the framework and gain competency in its use.