Grant: Travel Awards - Institute Community Support

Shifting the blame from healthcare providers in an adverse event to understanding the systemic root cause of an adverse event is called 'Just Culture.' The Just Culture Assessment Tool (JCAT) measures and directs resources toward improving Just Culture for patient safety. The research aims to understand how patient and resident physicians perceive Just Culture in Alberta Health Services (AHS) and revise the JCAT for use among these populations with consideration to the experiences of intersectional identities. The following project is a pragmatic qualitative patient-oriented study guided by constructivist grounded theory. We engaged 5 research partners (2 patients/ 3 resident physicians) in coproducing research outputs under the guidance of the Strategy for Patient-Oriented Research (SPOR) framework. Research partners were members of equity-denied groups with lived experiences of safety issues and/or event reporting within AHS. Sixteen interviews and semi-structured focus groups of 2-3 participants were conducted independently with patients and resident physicians. Domains of inquiry included demographics, barriers and facilitators to Just Culture, and the interaction between hierarchy/power, privilege, equity, and patient safety. Focus groups were audio-recorded and transcribed verbatim. Two independent coders open-coded and selectively coded data using Microsoft Word/NVivo software. Constant comparison was conducted to organize data into categories of information. Theoretical insights developed around Just Culture will inform the JCAT revisions. Study findings will contribute to the revision of the JCAT for use among a learner population of medical trainees and end-users of the healthcare system with consideration to intersectionality. Medical schools and AHS Patient Safety Department will benefit from study results and the revised JCAT for curriculum and policy development around safe learning and care environments.