Just Culture a term coined by David Marx, an engineer and attorney, is described as follows: On one side of the coin, it is about creating a reporting environment where staff can raise their hand when they have seen a risk or made a mistake. On the other side of the coin, it is about having a well-established system of accountability. A Just Culture must recognize that while we as humans are fallible, we do generally have control of our behavioral choices.

Just Culture philosophy makes a distinction between human error, at-risk behavior and intentional reckless behavior by looking at why an event happened in a systematic manner and determining whether the actions of the individual warrant counseling, remediation or punishment.

Just Culture uses a framework designed to enhance patient safety by implementing a learning and quality improvement approach to reducing errors and potential for errors  

The NC Board of Nursing has adopted this framework for evaluating practice-related complaints and is piloting a Just Culture partnership with hospitals and nursing homes to promote consultation and assist employers in identifying events that can be addressed in the practice setting versus those that would benefit from board intervention.

The Foundation for Nursing Excellence, working in collaboration with the NC Board of Nursing, the NC Center for Hospital Quality and Patient Safety and other key stakeholders in North Carolina, seeks to extend this learning and quality improvement framework into a variety of healthcare settings and regulatory systems with the long term goal of creating a statewide Just Culture Healthcare Community.