Just Culture Book Club Week 1 Blog Post – Chapter 1 (Retributive vs. Restorative Just Culture)

We continue our week 1 discussion of Sidney Dekker’s Just Culture: Restoring Trust and Accountability in Your Organization with some thoughts on Chapter 1 - Retributive and Restorative Just Cultures. When posting your thoughts, consider the following questions:

  • What is retributive vs. restorative Just Culture and how does each address individual and system accountability in reducing bad outcomes? What are the challenges to applying each approach within a Just Culture? How can those challenges be managed?
  • What are your personal experiences with retributive and restorative Just Culture? How did you feel about the experience? Did it make your place of work safer?
  • Dekker mentions that the two cultures are not mutually exclusive. Consider when each approach might be used, when the approaches may be inappropriate, and if they can exist without each other in healthcare organizations.
  • Consider James Reason’s Decision Tree for Determining Culpability of Unsafe Acts (below). How does it apply to Dekker's discussion in this chapter?

 

 

As ever, please feel free to contribute questions of your own in your discussion as well as things you may not have understood, or any alternative opinions/theories you've come across in the literature.

Next week's blog will focus on Chapter 2.

 

 

 

 

1 Response

  1. As Dekker pointed out in Table 1 of this chapter, Retributive justice seeks to answer questions: how bad did who break which rules, and what does the person deserve? In our experience in education, these questions often get us tunnel visioned. Investigations close quickly, and learning is somehow minimized. This risks violating one principle of HRO "Reluctance to Simplify". On the other hand, Restorative justice asks to inventory the occured harm, and focuses on the needs and obligations of different stakeholders. Dekker also suggests: To deliver meaningful and just practice, the process has to be a collaborative and inclusive one. To be effective, we need to engage the stakeholders and encourage questions and accounts from all sides. Furthermore, encounters between the the stakeholders need to happen. "Acknowledge the harm, restore the balance, and address your future intentions." This is more in keeping with other HRO principles such as "Deference to Expertise", "Commitment to Resilience", "Sensitivity to Operations". As a side question: I appreciate Sidney Dekker's discussion about technical errors, especially in the context of physician training. On page 27, he wrote "The benefits of technical errors almost always outweigh the benefits." ... meaning?

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