The ‘just culture’: why it is not just, and how it could be

Healthcare organisations have struggled to move from a culture of blame to a ‘just culture’, despite this being stated as a goal for several years. As a result of this cultural inertia, the original principles of a just culture require critical examination. A just culture is still seen primarily as a linear mechanism to apportion liability. Within our complex healthcare organisations, this approach is inadequate. This article proposes a revised approach to creating a just culture, which enables learning from all events, irrespective of outcome. There should be a focus on learning, rather than liability, with a presumption of good intention until proven otherwise. This more compassionate and respectful approach can help to move healthcare organisations towards a just culture and create an atmosphere of trust.