ArticleBMJ open2022
Role of the regulator in enabling a just culture: a qualitative study in mental health and hospital care.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Experiences and Impacts of Working in Organisations Undergoing Regulatory Scrutiny: An Integrative Review.Journal of advanced nursing · 2026Review
- Regulation and criminal law enforcement in healthcare: an uneasy alliance or partners in crime?BMC health services research · 2026Article
- Just culture and restorative just culture in healthcare settings: a scoping review of interventions, activities, factors and outcomes.BMC health services research · 2026Article
- Association of nursing error, just culture, and personality type: Health system promotion approach.Journal of education and health promotion · 2026Article
- Effects of the Interaction Between Time-on-Task and Task Load on Response Lapses.Behavioral sciences (Basel, Switzerland) · 2024Article
- Restorative Just Culture: An Exploration of the Enabling Conditions for Successful Implementation.Healthcare (Basel, Switzerland) · 2024Article
- Establishing a Just Culture: Implications for the Veterans Health Administration Journey to High Reliability.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Influence of external assessment on quality and safety in surgery: a qualitative study of surgeons' perspectives.BMJ open quality · 2024Article
- External inspection approaches and involvement of stakeholders' views in inspection following serious incidents - a qualitative mixed methods study from the perspectives of regulatory inspectors.BMC health services research · 2024Article
- Room for resilience: a qualitative study about accountability mechanisms in the relation between work-as-done (WAD) and work-as-imagined (WAI) in hospitals.BMC health services research · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesA just culture is considered a promising way to improve patient safety and working conditions in the healthcare sector, and as such is also of relevance to healthcare regulators who are tasked with monitoring and overseeing quality and safety of care. The objective of the current study is to explore the experiences in healthcare organisations regarding the role of the healthcare inspectorate in enabling a just culture.
designQualitative study using interviews and focus groups that were transcribed verbatim, and observations of which written reports were made. Transcripts and observation reports were thematically analysed.
settingThree mental healthcare providers, two hospitals and the healthcare inspectorate in the Netherlands.
participantsWe conducted 61 interviews and 7 focus groups with healthcare professionals, managers and other staff in healthcare organisations and with inspectors. Additionally, 27 observations were conducted in healthcare organisations.
resultsWe identified three themes in our data. First, professionals and managers in healthcare organisations perceive the inspectorate as a potential catalyst for learning processes, for example, as an instigator of investigating incidents thoroughly, yet also as a potential barrier as its presence and procedures limit how open employees feel they can be. Second, a just culture is considered relational and layered, meaning that relationships between different layers within or outside the organisation might hinder or promote a just culture. Finally, for inspectors to enable a just culture requires finding a balance between allowing organisations the time to take responsibility for quality and safety issues, and timely regulatory intervention when healthcare providers are unwilling or unable to act.
conclusionsIf regulators intend to enable the development of a just culture within healthcare organisations, they must adopt regulatory procedures that support reflection and learning within the organisations they regulate and consider mutual trust as a vital regulatory tool.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.