What does it mean to be accountable?

David Marx, JD, the keynote speaker at the upcoming Quality and Safety Symposium, believes how you learn from experiences is crucial to error prevention.

An engineer and attorney by training, he has dedicated his career to helping people address and deal with our “inescapable fallibility” as human beings. He’s spent time exploring this concept in several industries but will be speaking to us about how we can use human errors in health care to improve patient safety.

In preparation for the symposium, Marx recently shared more about his Just Culture Model, his own career path, and what he hopes to share with our faculty, staff, and students.

Can you tell us a little bit more about who you are and your career path?

I started my career in aviation at Boeing as an aircraft design engineer, and throughout my time at Boeing, I became increasingly interested in human error, organizing a human factors and safety group focused on safety assessment and improvement. My work in aviation sparked an underlying passion in Just Culture, an environment in which open reporting can lead to improved systems and behaviors.

How did you get involved in health care?

When the Institute of Medicine report came out in 1999, highlighting the impact of U.S. medical errors, I began to explore how to connect Just Culture in aviation to patient safety. I began asking fundamental questions: How can we design systems of justices to help us make better decisions and produce better outcomes for patients? How do we create a safe space to report errors while at the same time holding people accountable to best practices?

David Marx, JD

For those not familiar with the concept, what is Just Culture?

Just Culture is about teaching people a rational way to think about who we are, what we can achieve as human beings, and how to have compassion and empathy along the way. Ultimately, errors are going to occur in our organizations. Just Culture is a model for shared accountability in addressing those errors.

It’s a culture that holds organizations accountable for the systems they design and how they respond to staff behavior fairly and justly, rather than holding an individual accountable. It’s about finding the middle ground between a punitive environment and a blame-free one. Often in the workplace you don’t see justice, you only see injustice. Just culture addresses that by building a foundational sense of culture that everyone can buy into.

What is the most important factor in creating a Just Culture?

Leaders. Leaders have to role model their own fallibility and lead the way.  They have to model that sometimes we make the wrong choices but we can use them to help us get back on the right path.

What will we be able to take away from your presentation?

  • How can just culture be applied to health care?
  • What does it mean to be accountable?
  • How do we hold each other accountable?
  • How to design a good system for work place justice?

To hear more from David Marx, register for the seventh annual Quality and Safety Symposium and Research Poster Session Nov. 20–21, 2019.