Creating a Just Culture in Healthcare: Strategies for Change
Guests
Dr. Simon Fleming
Dr Fatih Mehmet Gul
In this episode of the Chief Healthcare Officer Podcast, Dr. Fatih Mehmet Gül interviews Dr. Simon Fleming, an orthopedic surgeon and advocate for cultural change in healthcare. They discuss the challenges of creating a just culture, the impact of bullying and discrimination, and the importance of leadership in fostering a respectful work environment. The conversation also emphasizes the need for effective strategies to implement cultural change and the role of education in shaping future healthcare professionals.
Unable to listen to the full episode? Fast-forward to the key discussion points via the players above or read the key takeaways:
The Problem of Toxic Healthcare Culture: Dr. Fleming’s research found that over 70% of orthopedic trainees in the UK had witnessed or experienced negative workplace behaviors, confirming widespread toxic practices.
Root Causes of Toxicity: Traditional healthcare culture, especially in Western medicine, is rooted in hierarchy, and power imbalances, leading to resistance to cultural change. Problems are not isolated to one specialty or region; they're pervasive across healthcare, affecting diverse healthcare professionals globally.
Cultural Change Through the Vanderbilt Model: The Vanderbilt Cup of Coffee model is recommended for addressing workplace issues, starting with informal conversations about negative behaviors and escalating interventions based on repetition and severity. This model emphasizes psychological safety, active bystander training, and assertiveness to empower healthcare staff to address misconduct effectively.
Leadership's Role in Just Culture: Leaders must advocate for and embody a "just culture" where open communication, psychological safety, and accountability are prioritized. Leadership should avoid only top-down approaches; even junior team members need to feel empowered to voice concerns.
Education's Role in Culture Change: Education should address common resistance, such as defending tradition and reluctance to change, through a compelling vision and practical, inclusive approaches.
