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On Research

Ashley Johnson's blog

A blog by Associate Editor Ashley Johnson


ashley.johnson@nsc.org


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Culture of blame

December 16, 2013

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How does your organization respond when an employee is involved in a workplace incident? Does it focus on assigning blame and doling out punishment, or offer support to the worker and highlight lessons learned?

These questions are at the center of a small study recently published in the British Journal of Surgery (Vol. 100, No. 13). Anna Pinto, research psychologist at the Centre for Patient Safety and Service Quality at Imperial College London, and a team of researchers interviewed 27 surgeons to find out how surgical complications affected their well-being.

Serious complications, such as a stroke resulting from carotid artery surgery or an inter-operative death stemming from a surgical error, were found to have a significant emotional impact on surgeons. Pinto said they may suffer psychologically and have trouble concentrating or making decisions. That’s understandable – having a patient incur further injury on your watch (and possibly because of your actions) can’t be easy.

But what I found most interesting was how surgeons felt about their employer. About 70 percent described their employer’s response as “inadequate,” citing a culture of blame that assumed incidents reflected a lack of competence on the surgeon’s part.

“Debriefing or effective mentoring in the aftermath of serious incidents was rare,” Pinto said. “Organizations were often quoted as reacting in a punitive manner and with little understanding of the wider systemic problems that can contribute to complications.”

Sound familiar? The tension between blaming the worker versus examining systemic causes comes up all the time in safety, such as in discussions of Heinrich’s safety theories and behavior-based safety.

A culture of blame doesn’t just hurt the individual being blamed. The organization loses out on a learning opportunity because the worker may feel isolated and reluctant to share his or her experience.

A more productive approach would be promoting an open, non-judgmental culture. Pinto recommended using debriefing sessions to identify lessons that can help improve surgical practice rather than pass blame. She called informal and formal networks of support paramount because they “allow staff who work in high-risk professions to deal with the aftermath of serious safety incidents in a constructive way and they minimize the long-term adverse effects of such incidents on staff’s personal and professional well-being.”

In other words, helping the individual cope can benefit the organization and help prevent other incidents – a lesson that applies to any workplace.

The opinions expressed in "Research Spotlight" do not necessarily reflect those of the National Safety Council or affiliated local Chapters.

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