Newspaper Calls for Reform at Military Hospitals by Using ‘Just Culture’ Model

Military hospitals provide care for active-duty service members and their families, making them a crucial part of the nation’s health-care system. Lapses in care at several military hospitals, however, have led to calls for improvement in patient care by implementing a culture of safety, or a “just culture,” in which medical errors can be reported without fear of reprisal, according to a recent editorial in the Boston Globe.

Three of the largest hospitals in Boston have implemented the “just culture” model for reporting errors, according to the Boston Globe. These include Massachusetts General Hospital, Brigham & Women’s Hospital and Beth Israel Deaconess Medical Center.

Under the “just culture” model, anyone – from the custodial staff to physicians and surgeons – may report suspected errors without risk of punishment for bringing the problem to light. In fact, the hospitals encourage error reporting. Emphasis is placed on fixing a system that allowed an error to occur rather than on blaming an individual for causing an error, according to the Boston Globe.

A system that focuses on finding and fixing errors rather than on blaming those who report them provides a more efficient route to reducing harm and improving patient care. The problems caused by medical errors seem to be particularly common in smaller military hospitals, according to the New York Times, which reported in September on the difficulties faced by small military hospitals in providing adequate care.

But, as another recent New York Times article noted, military hospitals struggle to implement systems like the “just culture” model. Military chain of command, a system that works well in the field, has had the effect of chilling medical error reports. According to the Boston Globe, medical personnel have reported being transferred or passed over for promotion after reporting problems with patient care.

Placing the blame on individual reporters rather than focusing on fixing the system is the antithesis of the “just care” model. Yet changing the system may require significant work. For instance, leadership at military hospitals changes every three to four years, according to the Boston Globe, making it difficult for any new system to “stick.” In addition, the military hospital system is divided into three units, and its resources are already strained by ongoing wars, the newspaper notes.

If you believe that you, your child, or another loved one has received substandard medical care at a military hospital in Washington, contact the Seattle malpractice lawyers at Morrow Kidman Tinker Macey-Cushman, PLLC. Your initial consultation is free and confidential.