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Healthcare

Utilizing the Just/Non-Punitive Approach

There are several advantages of using the just/non-punitive approach instead of relying on punishment and termination when investigating an adverse event (Mahajan, 2010). The latter response is historically common, but has been exposed as an inefficient and damaging reaction to adverse events. In contrast, the non-punitive approach to mistake management removes the personal element in favor of objective observations and the systematic reduction of errors. However, the just/non-punitive approach must be implemented in such a way that it promotes improvements, rather than representing a freedom from professional responsibility.

There is a major problem with the current incident reporting system in health care services (Chiang et al., 2011). Medical professionals who have been consistently exposed to a culture of blame and punishment tend to regard incident reports as potential sources of career derailment. This sense of fear does nothing to support the improvement of health care because it makes it practically impossible to gather accurate information about potentially preventable mistakes. Professionals also experience an undue amount of stress in punitive environments that ironically increases the odds of errors taking place. A non-punitive culture encourages reporting and relieves excessive pressure on professionals by eliminating the fear of being prosecuted for every minor miscalculation.

Another major difference that sets the non-punitive approach apart from blame and punishment is the emphasis on data acquisition, analysis, and application with the ultimate goal of resolving preventable issues that could result in an adverse event. Common strategies arising from this approach address the efficiency of teamwork interactions, involving health service professionals in evaluative processes, and promoting improvements rather than reprimands.

References

Chiang, H. Y., Hsiao, Y. C., Lin, S. Y., & Lee, H. F. (2011). Incident reporting culture: scale

development with validation and reliability and assessment of hospital nurses in Taiwan.

International Journal for Quality in Health Care, 23(4), 429-436.

Mahajan, R. P. (2010). Critical incident reporting and learning. British Journal of Anaesthesia,

105(1), 69-75.