Creating a Just Culture: A Nurse Leader's Guide

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Creating a Just Culture: A Nurse Leader's Guide

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Creating a Just Culture: A Nurse Leader's Guide



Step-by-step guidance to create and sustain a just culture at your facility

This practical resource explains the process of creating and sustaining a just culture in which staff members are encouraged to report adverse events to improve quality care. You’ll get sure-fire strategies to gain buy-in from leadership, improve employee satisfaction, and turn mistakes and near-misses into useful data to improve processes and reporting. Help your nurses understand it’s not the “who” but the “what” that went wrong.

Click here to download a sample tool that provides you with a timeline for just culture implementation!

This book will help you:

  • Overcome potential roadblocks to culture change with successful strategies from accomplished patient safety, risk, and nursing experts
  • Motivate staff to report adverse events
  • Discover how a just culture increases patient safety, nurse satisfaction, and retention
  • Evolve your current culture into a just culture using the easy-to-understand, step-by-step instructions


You also receive helpful tools such as:

  • Sample timeline for just culture implementation—Download a sample here
  • Just culture policy from a leading hospital
  • Staff education checklist

Take a look at the table of contents

Chapter 1: Why a Just Culture?
National Emphasis on Patient Safety
Avoiding Toxic Work Environment
Your Professional Duty
Why Staff and Patients Should Care
Enhancing Recruitment
Retaining Staff
Get Ahead with Public Reporting

Chapter 2: Assess Your Organization
Policy and Procedure
Mandatory Reporting Policy and Regulation
Assess Your Staff’s Knowledge
Undertake a Cultural Assessment

Chapter 3: Plan the Change
Leverage Current Strengths
Identify Stakeholders
Identify Champions
Establish Symbols of Change

Chapter 4: Identify Desired Outcomes
Increasing Occurrence Reporting
Reporting New Errors
Open Discussions of Change
Use of FMEA

Chapter 5: Implementation Strategies
Provide Training
Supporting Errors Occurring Within
Your New Culture
Emphasizing Values of Courage,
Honesty, and Integrity
Teaching Peers To Support and Comfort
Streamlining Error Reporting

Chapter 6: Evaluate the Change
Benchmarking Within and Outside of Your Organization
Resurveying Your Hospital
Monitoring Your Progress

Chapter 7: Case Scenarios and Expert Advice

Chapter 8: Weighing Ethical Decisions
Cultural Barriers to Disclosure
Items to Include in Disclosures
Who Should Disclose
Exceptions to Disclosure

Meet the Authors:

Vivian B. Miller, BA, CPHQ, LHRM, CPHRM, FASHRM, is the senior risk management specialist for the American Society of Healthcare Risk Management, serving as the internal staff resource on healthcare management content. She has more than 25 years of progressive consultative and managerial experience in professional liability claims, patient, safety, quality, and risk management services within the insurance and healthcare delivery industries.

Terry L. Jones, RN, PhD is an assistant professor of clinical nursing, and nursing administration and nursing systems at the University of Texas at Austin School of Nursing. Prior to that she served as director of care management and interim vice president of nursing administration and chief nursing officer at Parkland Health & Hospital System in Dallas, TX.

Faculty Disclosure Statement: HCPro, Inc., has confirmed that none of the faculty/presenters, planners, contributors, or their partners/spouses have any relevant financial relationships to disclose related to the content of this educational activity.

Continuing Education:

If you would like to find out about the availability of nursing contact hours on this or any other HCPro nursing book, please visit our Continuing Education information page, here.

Published: January 2011