Blame Is Not a Game: Healthcare Leaders' Perceptions of Blame in the Workplace

Cheryl L. Mitchell, PhD, Fielding's School of Human and Organizational Development

This exploratory research increases knowledge and understanding of blame in the workplace. Attribution theory, moral philosophy, and social cognition provided a theoretical framework to understand individual blame determination as a precursor to understand systemic blame. Systemic blame is informed by complex systems theory and research on “no blame” cultures in a healthcare setting.

Interpretive description, supported by applied thematic analysis, provided the methodological framework for this qualitative study. The 17 senior leaders interviewed for this research study were selected through purposive sampling, and individually had an average 28 years of experience in healthcare. The semi-structured interviews were designed to gather experiences and stories that informed the participants’ perspectives on blame in the workplace.

Constant comparative thematic analysis of the data resulted in four main findings. First, blame is prevalent in the workplace. Second, blame begets blame through a vicious cycle of blame. In this cycle there is often unwarranted blame. Blame feels bad, which results in fear of blame and avoidance of blame. One way to avoid blame is to blame someone else. This positive reinforcing feedback loop of blame creates a culture of blame. Third, a culture of blame includes characteristics of risk aversion and mistrust. Risk aversion decreases innovation, and mistrust decreases transparent communication. Fourth, blame has an inverse relationship to accountability, where less blame may result in more accountability. These findings both confirm and contradict the current literature. The resulting conclusion is blame is not a game.