Which of the following is an element of Just Culture?

• A. Root cause analysis
• B. Extreme ownership
• C. Shareholder accountability
• D. Avoidance of blame

Answer: (D)

Just Culture centers on avoiding blame to encourage reporting of mistakes and near-misses, because when people feel safe to speak up, organizations can learn from errors and put systemic improvements in place. This non-punitive, learning-focused approach is what makes it possible to uncover underlying system failures rather than hiding issues. At the same time, accountability is still present for reckless behavior or deliberate violations, but the emphasis remains on creating a safe environment for disclosure and improvement.

Root cause analysis is a common tool used to understand how failures happen, but it’s not the defining element of Just Culture itself. Extreme ownership reflects taking personal responsibility, yet it isn’t the formal principle that differentiates Just Culture. Shareholder accountability isn’t relevant to the patient-safety framework.