1. Just Culture Implementation – Phase 2 Training and Expectations Stephanie Sobczak and Jill Hanson WHA Quality Improvement Managers 1

2. Today’s Call Past 30 Days Presentation – Aspirus Wausau Implementation – Phase 3 – Training – Staff Roles and Expectations Partners for Patients Mid Point Event (March 12-13) Just Culture “Wave Two” 2

3. 3 ACTION ITEMS Request Just Culture Algorithms from WHA (if you didn’t already) In your core team, practice using the Just Culture Algorithm with your hospital cases Related to your implementation plan, discuss how you will introduce the algorithm to your management staff. Who will use the algorithm? In what circumstances will it be used? Past 30 Days

4. Aspirus Wausau Just Culture Training 4

5. What to Expect of a Just Culture Manager Understands human fallibility, human reliability and drift; and how to respond to and manage behaviors Sets clear and consistent expectations : – For the result – The risk to be managed – To rules/guidelines to achieve it – The key behaviors to do it well Gives voice to the risk in the system Works daily to raise perception of risk Accords correct priority for tasks/results 5

6. Developing Your Training Plan Goals Develop consistent understanding and management of human error, at-risk behavior, and reckless behavior Achieve an appropriate balance between a “blameless” culture and an “accountable” culture that supports patient safety improvement 6

7. Components for JC Train the Trainer Should cover: Explaining a culture of safety Management of risk Behavioral choices Event analysis Applying fair and just principles after an event Staff roles and expectations Walking thru the Just Culture algorithm 7

8. Human Resources – Staff Roles Help with managerial competencies Monitor the use of disciplines Help staff understand their duties/expectations 8

9. Quality Directors/Risk Managers - Roles Facilitate event analyses Assist with system re-designs 9

10. Just Culture Manager – Role Know your critical and important tasks and how to achieve them safely Know, understand and choose to follow procedures Understand and manage the impact of personal performance shaping factors 10

11. Just Culture Manager – Helping Others Limit distractions Change peer pressure thru peer coaching Manage interpersonal differences with co- workers Come forward when you see risk in the system Choose to do the right thing, the first time! 11

12. Setting Staff Expectations Just Culture is about staff: Looking for risks around them Reporting errors and hazards Helping to design safe systems Making safe choices – Choices that align with the organizational values (do they know what these are?) 12

13. WHA Partners for Patients Mid Point Event March 12-13 “Catch the Wisconsin Wave” Registration link: http://events.SignUp4.com/13PFP031112 13

14. Poll Question Are you planning on attending the Partners for Patients Mid Point event? 14

15. Mid Point Event – JC Breakout Session Wednesday March 13 - 2:15 – 3:00 pm Session attendees identify where they are in the Just Culture journey (via sticker) 1.Have worked or implemented a Just Culture 2.Working on becoming a Just Culture 3.New to Just Culture – interested in learning more – Break into discussion groups with each having someone in the 1, 2, and 3 category 15

16. JC Breakout Session Discussion Round Robins – How has implementing Just Culture changed the work environment? – What has surprised you since implementing a Just Culture? – What advice do you have for someone just starting out on this journey? Staggered questions; ten minutes to discuss; five minutes to report out 16

17. Breakout Session – Feedback Gathering What would a “Wave Two” look like? Deep Dive Workshop Feedback survey – Does the collaborative model we’ve structured for this initiative still work? – Are the resources from WHA adequate? – How can WHA assist with your Just Culture journey? – As a Wave One participant, would you be interested in the Just Culture Deep Dive Workshop? 17

18. Just Culture Deep Dive Workshop 18

19. The Next 30 Days ACTION ITEMS Register for the Partners for Patients Mid Point Event (http://events.SignUp4.com/13PFP031112 ) Continue to send in your scenario examples (for our Spring webinar discussions) Develop your training plan Identify what your staff role and expectations will be regarding your fair and just culture 19

20. Thank You! Questions? Jill Hanson Stephanie Sobczak March 6 th Just Culture Webinar 10-11 am Event Investigations 20