ArticleBMJ open2025
Understanding and reframing clinical errors through just culture: protocol for the DECIDE mixed-methods study in Spanish healthcare and community contexts.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06835517 (Design of Tools to Transform the Conceptualization of Clinical Error Within and Outside Healthcare Centers, Social-health Centers, Hospitals and Healthcare Management), which is not on this map. Cited by 3 papers.
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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.
Design of Tools to Transform the Conceptualization of Clinical Error Within and Outside Healthcare Centers, Social-health Centers, Hospitals and Healthcare Management
Who cites it
3 citing papers in PubMed.
- Cognitive Tunneling in Obstetrics and Gynecology: A Critical Review of Implications for Clinical Practice and Mitigation Strategies.Diseases (Basel, Switzerland) · 2026Review
- Triage Nurses' Perceptions of Patient Safety Errors During Triage in the Emergency Department: Qualitative Thematic Analysis Study.Healthcare (Basel, Switzerland) · 2026Article
- Patient safety culture and climate in Estonian hospitals: a cross-sectional study on employees and background characteristics.BMC health services research · 2026Article
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatient safety culture plays a crucial role in reducing clinical errors. By improving healthcare professionals' and patients' understanding of human fallibility and error attribution, patient care can be enhanced, fostering greater engagement from both groups. A Just Culture approach, which balances accountability and learning from errors, is a key factor in fostering this safety culture. The DECIDE Project aims to: (1) examine the conceptualisation of human fallibility within and beyond healthcare, (2) identify barriers and facilitators to Just Culture adoption, (3) assess the impact of psychoeducational interventions on professionals' and social leaders' attitudes toward clinical errors and (4) develop a roadmap for Just Culture implementation in healthcare. METHODS AND ANALYSIS: A 36-month mixed-methods study including qualitative research, a survey of 1255 healthcare professionals, an experimental study with 180 participants (60 per arm) testing interventions based on cognitive dissonance and reasoned action theories and a consensus conference to develop a Just Culture roadmap. Participants include professionals from hospitals, primary care, long-term care, nursing homes and social leaders in Spain. The qualitative data collected during stages 1 and 4 will be analysed using MAXQDA software. In identifying factors related to the implementation of Just Culture during stage 2, ANOVA, t-tests and multiple linear regression will be conducted. To examine the effects of the interventions in phase 3, a linear mixed-effects model for repeated measures will be employed. ETHICS AND DISSEMINATION: This study has received ethical approval from three institutional review boards. Findings will be disseminated through peer-reviewed publications, conference presentations and policy recommendations aimed at integrating Just Culture into national and international patient safety strategies. By promoting a constructive approach to errors, the project could enhance incident reporting, strengthen professional engagement in safety policies and foster a culture of learning and accountability. Its findings will guide policy recommendations for integrating Just Culture into national and international patient safety strategies, with potential applications beyond Spain. CLINICALTRIALSGOV IDENTIFIER: NCT06835517.
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