This year we are excited to have Matthew Streger and Michelle Kobayashi present a workshop focusing on risk mitigation and Just Culture. Matthew Streger is an expert in his field and has developed this special program for paramedic supervisors and EMS leaders. The following is a brief synopsis of this program.
Medical errors are the third leading cause of death in the United States, trailing only cardiac disease and cancer. Despite this fact, most healthcare entities have not been successful in addressing both the errors themselves and the organizational culture that leads to errors. Rather than learning from mistakes, providers have historically been taught to hide their mistakes, and the punitive culture of progressive discipline further hurts this process.
Just Culture is a system for analyzing human behavior, categorizing decision-making, and helping providers make better risk-benefit decisions. These decisions can be clinical, operational, or administrative.
The Just Culture program typically has two parts. The first is designed for street-level providers. It reviews the scope of the medical error issue and compares the healthcare industry to the commercial aviation industry, then looks at other systems of error prevention and correction. The Just Culture program then reviews the three categories of decisions and what organizations do with each type of behavior. This includes interfacing with common human resources systems of discipline.
This program has been designed for supervisors and managers. The basic elements of the program above are unchanged, but the investigative process is reviewed in depth. This includes starting the investigative process, the owner-validator process, review of conflicts, and specific steps for a thorough and objective investigation. This process can be used for any type of adverse event.
Prior to the start of the Superintendent Workshop, all those enrolled will be invited to attend the Keynote presentation by Former Chief of the Defence Staff for Canadian Forces, General Rick Hillier.