What is the role of individual accountability in patient safety? A multi-site ethnographic study.
The concept of a just culture has become popular for balancing individual accountability with a systems approach to patient safety. This study used insights from practice theory, political science, ethics, and empiric data from five ethnographic case studies to illustrate the fundamental interdependence of systems and individuals at all levels. The authors argue apportioning responsibility between systems and the individuals within them leads to a false dichotomy. They suggest that rather than attempt to balance these two forces, organizations should appreciate their intertwined effects. Senior author Mary Dixon-Woods elaborates on the relationship between individuals and systems in a PSNet interview.