A Statewide Approach to a Just Culture for Patient Safety: The Missouri Story

The Missouri Just Culture Collaborative brought together health-care providers, regulators, and other key stakeholders to learn and implement the principles of Just Culture. A survey was used to determine baseline understanding of Just Culture. Under the leadership of the Missouri Center for Patient Safety, 67 health-care providers and regulatory agencies worked together to implement aspects of Just Culture. The collaborative led to an improved understanding between providers and regulators about barriers to implementing true Just Culture and how regulators can support provider efforts to improve the safety culture. Also, healthcare leaders who more actively participated in the collaborative's interventions appeared to gain a better understanding of staff perceptions of their organization's safety culture. While implementation of Just Culture is a long journey, Missouri has set the stage for health-care providers and regulators to move together toward a true Just Culture to improve patient safety.