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Bringing Just Culture into the Classroom

The Problem:
While MUSC’s MHA program had a rich theoretical understanding of how to teach leadership to students, it lacked a comprehensive framework for teaching students to respond when adverse events occurred and a best practice approach for improving the human systems of hospitals.

The Goal:
Find a real-world decision-making philosophy that would be easily adaptable to hospitals and provide concrete management tools for students to use after they graduate. The tool ended up being Outcome Engenuity’s Just Culture training.

Method & Implementation:
OE’s Just Culture training provides management skills and tools that, combined with values and shared practices, breed an accountable culture across the entire span of an organization. The central goal of Just Culture is to give high-consequence organizations a way to become a Highly Reliable Organization (HRO). Central to installing a Just Culture is Marx’s Outcome Engenuity Workplace Accountability model. This clear, concise approach for improving systems establishes a culture where employees feel safe to identify errors or bad choices because process improvement, rather than punitive action, is the most common result. The model focuses on the decision-making process in a fair and equitable way that avoids the “outcome bias” that comes from overreacting to an adverse event and instead thinking rationally through what led to the event.

Tom Crawford, a professor at MUSC, built this model directly into his human resources class by speaking frequently about Just Culture as part of his lecture and assigning Marx’s novel-textbook hybrid Dave’s Subs into the course reading.

“It’s the focal point of every single class,” he says. “I present real-live case study scenarios to supplement what they are learning, and it’s interesting to see the students make the same mistakes [that I did] initially. But then they start applying the Just Culture methodology, and you can see how it will influence the communities they will be leading later. And they begin to see, more than anything, the relevant application of how this will help transform each of them into consistent leaders.”

Crawford has since taken a step further and made the certification process with OE part of the core course curriculum.

While Crawford has only been teaching the model for a few years, but it’s already won rave reviews from his students.

“As we progressed, I got so much more out of reading the book and the practical discussions of how it applied to not only healthcare but management and leadership decisions in any setting or industry,” says Parker Rhoden, one of the recent graduates from the program and Crawford’s class. Rhoden is now a certified Champion of Just Culture and says it will “definitely pay off in the long-term with how I manage and lead people throughout my career.”

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