Restorative Practices in Healthcare
You may be wondering how to operationalize a form of justice (and community building) that seems radically different than what you've experienced in healthcare before? The truth is that RJ helps bring out the best in people by creating the dialogical conditions that cut across power, privilege, hierarchy, and social identity––and it empowers communities to truly see each other, better understand each others' lived experiences and needs, and collaborate on next steps for redressing harm and changing the culture.
RJ Procedural Continuum
RJ’s three-tier design, its procedural pyramid, makes it is transferable to the healthcare settings since it can be used to:
- Create more supportive, inclusive, and resilient communities (Tier 1)
- Respond to harm or conflict in a non-punitive yet accountable manner (Tier 2)
- Facilitate community reintegration with individualized social support (Tier 3)
It's important to note that restorative practices can range from informal processes such as simple check-ins and "restorative chats" to formal practices such as community building circles, victim-offender dialogue, climate circles, restorative conferences, and even shuttle dialogue between harmed parties and the persons responsible for harm (who do not wish to meet in person).
See below to learn more about facilitator-led RJ practices we've used in healthcare. As you've already discovered, RJ is a values-based, ethical framework where relationships matter. Therefore, in order to effectively enact these practices and improve the quality of communication, both RJ practitioners and participants must be committed to shifting their mindset from a retributive one to a restorative one.
Restorative Mindset (Foundational)
Community Building Circles (Tier 1)
Community Building Circles (Tier 1)
The restorative mindset, which is a prerequisite for all other restorative practices (Tiers 1-3), is the benevolent, respectful and equity-minded dialogical approach RJ practitioners and participants use to effectively communicate with each other. Some describe this as a "restorative way of being."
Community Building Circles (Tier 1)
Community Building Circles (Tier 1)
Community Building Circles (Tier 1)
Tier 1 practices, including community-building circles, are used to build and strengthen relationships through peaceful, inclusive storytelling. They create opportunities for interpersonal connection, mutual understanding and collaboration.
Restorative Conferences (Tier 2)
Circles of Support and Accountability (Tier 3)
Circles of Support and Accountability (Tier 3)
Tier 2 practices, including restorative conferences and climate circles, allow communities to respond to individual or communal incidents of harm or misconduct. Climate circles, in particular, can be used to provide inclusive dialogue, healing, accountability, and action plans.
Circles of Support and Accountability (Tier 3)
Circles of Support and Accountability (Tier 3)
Circles of Support and Accountability (Tier 3)
Tier 3 practices, including circles of support and accountability (COSAs), are used to ameliorate difficult reintegration processes for people who have been separated from the community due to suspension or leave of absence.
Addressing Healthcare Climate Concerns
LEARN MORE: Click here for a link to my research, which demonstrates RJ can help improve psychological safety, build and strengthen relationships, and improve organizational climate in medical learning environments.
Responding to Malpractice Harm
LEARN MORE: Click here to learn how the New Zealand Ministry of Health used RJ to respond to surgical mesh harm.
Addressing Healthcare Inequities
LEARN MORE: Click here to read an article I collaborated on with Dr. Ruby Long, et al. (2022) that recommends using RJ to help engage the voices of vulnerable populations in the design of crisis standards of care.
