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What is a restorative just & learning culture?
A restorative just culture (RJLC) provides the foundation for practice changes that are conducive to reporting, engagement and safety improvement.
A restorative just culture identifies and sets out to repair the harms that have resulted from an event. It asks about impacts, needs and obligations. It holds people accountable in a forward-looking way: what do we do now to heal and improve?
A restorative, just culture fosters a psychologically safe work environment. It has been demonstrated to counteract a blame culture & provide an ideal framework to build trust among staff by creating an environment in which all stakeholders involved in an incident can feel safe to be open to learning & improving care systems. (Turner 2021)
How is RJLC supporting Zero Suicide Healthcare?
The complexity of healthcare means that restorative approaches are likely to identify the deeper conditions that could result in an accident.
Seeing suicide as a never event forces an organisation to use best practices, apply continuous quality improvement, and emphasise reducing errors while holding the system to account, not individuals who work in the system.
Restorative approaches are open to multiple voices. Practitioners are not seen as offenders but rather as inheritors of organisational, operational or design issues that could set others up for failure.
Healthcare providers should demand that their system adopt robust suicide prevention practices for the safety of those in their care as well as for themselves.
Restorative just and learning culture focuses on forward-looking accountability.
It is created by asking what should be done and who should be implementing it and assessing whether it works.
It supports goal setting and moral deliberation about the practical processes needed to achieve the goals. It also clarifies the role that a person seeks to play in making the goals happen.
Introducing a restorative just & learning culture
for Zero Suicide Healthcare
A just culture is a culture of trust, learning, and accountability. For many working in complex health systems the experience of incident reviews often takes a retributive approach focused on:
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Which rule was broken?
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Who is responsible?
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How bad is the violation and what should the consequences be?
Restorative approaches ask very different questions in the wake of an incident:
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Who is hurt?
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What are their needs?
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Whose obligation is it to meet those needs?
Register your interest in the four e-learning modules which introduce the principles and practices of a restorative, just and learning culture. They aim to provide a common understanding for the organisational leaders who wish to lay this as a foundation for implementing Zero Suicide Healthcare.
In this video Professor Sidney Dekker provides an overview of restorative just culture and its application within comlpex organisations.
Module 1
The old and the new view of human error
Healthcare systems are complex. Systemic factors such as resource availability, staffing, time constraints, and contradictory rules and standards, impact on the complex and dynamic work of healthcare professionals.
The way in which we respond to failure impacts widely. It can have a detrimental affect on those working in the system as well as on those the system seeks to serve.
Module 2
Understanding reactions to failure
Healthcare systems exist in a changing world. Too often they are under severe resource and performance pressures and the environment, economics, technology and regulatory context all change over time.
In complex systems when adverse events happen they are not linear. However, hindsight bypasses the circumstances of the moment and does not seek to understand why people made the decision they made at the time. It inevitably leads you to the outcome which you already know.
Module 3
Introducing retributive and restorative practices
A variety of people can get hurt by an incident. This is not limited to the immediate victims. It also includes those practitioners involved in the incident and even the organisation and the surrounding community.
A restorative outcome requires all people involved to have their voices heard. Hurt creates needs and needs create obligations. Restorative practices systematically consider those needs and work out collaboratively whose obligation it is to meet those needs.
Module 4
Building a psychologically safe workplace
Every day healthcare professionals apply their knowledge and practise their skills within excessively complex situations. At times this results in unintended outcomes for the patient. The people impacted by these unintentional errors are the first and obvious victims of medical mistakes. However, those who care for them are also wounded by the errors. These are health professionals who experience harm - they are the second victims.
Need to know more about RJLC?
Below are some additional resources that are designed to assist you work within your organisation to strengthen a restorative, just and learning culture.
We recommend that you first organise a bespoke workshop for your organisation and then this package of resources will be available to you at no additional cost.
This infographic explains the importance of developing a restorative, just and learning culture as an underpinning of the Zero Suicide Healthcare approach.
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Facilitator Guide
Tips and Techniques
Powerpoint presentation
This Facilitator’s Guide provides facilitators of the workshop Restorative, just and learning culture: Building a Foundation for Zero Suicide Healthcare with a roadmap for their session. Whether someone is a seasoned expert or new to facilitating, this guide is intended to keep the workshop on track in terms of the learning objectives, agenda and material, activities/ discussions and pacing.
This resource is designed to support Operational Managers who are leading the RJLC program. It provides facilitation strategies, tips and techniques and is intended to be used in conjunction with the Facilitator’s Guide. These documents are designed to support organisations seeking to achieve a shift in culture from one that is focused on retributive justice to one that provides a supportive and psychologically safe workplace environment.
This resource provides you with a Powerpoint presentation set of slides for your own RJLC workshop. It aligns to the Facilitator's Guide for you to introduce RJLC to your teams.
Complete the online learning modules
The four program modules introduced above are designed to support your health service to strengthen a restorative, just and learning culture.
Each one is organised into short lessons, needing only 15-20 minutes to complete, plus a summary section. Encourage your team to adopt a micro-learning approach by completing one lesson each day over a week.
The modules include video, downloadable journal articles and quizzes and activities to help reinforce the learning. As there is media with audio—you need headphones or speakers and ensure your computer is not muted.
Remember, there are times throughout the program that the discussion of suicide will arise. It is important that all participants consider their own self care. Please think about a trusted person or service you could speak with should you have any concerns about your wellbeing or the wellbeing of others.
Participate in a bespoke workshop
Following completion of the modules ZSIA offers a bespoke workshop for your health service. It will help you plan how to work towards strengthening a restorative just & learning culture.
During this workshop we will coach your team to develop a blueprint for a restorative just and learning culture program.
At the conclusion of the workshop participants will:
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Understand and apply the principles and practices required for restorative just and learning culture
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Translate cognitive knowledge into actionable real-world skills to apply in the workplace
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Have an action plan for implementing culture change within the health service.
Join the knowledge RJLC network
As the number of health services complete the modules and bespoke training increases, we will offer the opportunity to join the Knowledge Network. Together we can share successes and challenges with those leading both Zero Suicide Healthcare and restorative just and learning culture.
As a ZSIA subscriber you will receive:
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updates and ongoing communications from ZSIA to support your teams
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early access to new resources and programs to support implementation
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invitations to join the ZSIA Community of Practice to share your learning with others
Connecting
Join others strengthening health system culture across Australia. Share learning and discuss opportunities, challenges and solutions to implementing RJLC
