Introducing ‘Just Culture’ to the NEMT Industry

Reducing risk for our NEMT passengers and drivers is essential for an operating medical transportation company. Unfortunately, the daily routine of transferring passengers is filled with high-risk operations and interactions that can lead to catastrophic injuries and, in some cases, fatalities.

As a business owner, if you are not thinking about safety with every NEMT trip you fulfill, you are setting the company up for costly litigation. After an accident, It isn’t easy to defend an organization on why they don’t require their drivers to complete a defensive driving course or a mobility device securement training.

This lack of industry focus leads to articles like “Wheelchair tip-overs: A Tort Lawyers Paradise” and “Who is driving the van? A Look at NEMT Accidents. We then wonder why NEMT vehicle insurance is so insanely expensive.

To promote best practices, NEMT companies should establish a focused approach to workplace safety and launch a “Just Culture” initiative.

What is a Just Culture?

Over the past decade, a movement known as Just Culture has emerged in high-risk professions, including air medical services and hospital systems. Historically, the model in many workplaces has been a punitive one in which mistakes are met with immediate disciplinary action. Unfortunately, this is a myopic practice that fails to address the actual causes of the error and creates an environment of fear.

Several research studies show that most errors do not result from individual recklessness. Blaming them does not make the organization safer or prevent someone else from committing the same mistake. According to the Patient Safety Movement, even the most well-trained and conscientious employee is still a human being who will make mistakes. Experts have discovered that punitive systems – those focused on errors rather than at-risk behaviors and on blame and punishment rather than improving the root causes – actively discourage people from reporting mistakes. Encouraging the attitude of asking what is to blame instead of who is to blame is at the heart of Just Culture.

A Just Culture creates a workplace environment that balances transparency and accountability. The processes recognize that errors represent predictable interactions between humans and the vehicles, systems, or equipment they work with. It also considers that competent professionals make mistakes and acknowledge that even experienced professionals will develop unhealthy work habits.

The foundational tenets of “Just Culture” require adherence to two guiding principles:

• The acceptance that human error is inevitable, and organizations must review their practices, policies, and processes to manage the risk of mistakes.

• Individuals within an organization should be held accountable for their actions if they knowingly disobey safety protocols or procedures.

Essentially, a Just Culture encourages an environment where individual mistakes are not punished but are instead analyzed against the policies to review any inconsistencies in an organization.