Restorative Initiatives in Healthcare: Moving from Blame to Healing
Restorative Initiatives in Healthcare: Moving from Blame to Healing
When healthcare harm occurs, too often the systems designed to respond unintentionally deepen the wound. Families, patients, and even staff experience what researchers call compounded harm—trauma created not just by the incident itself, but by institutional responses that exclude, silence, or stigmatize .
An international paper led by Jo Wailling and colleagues shines a light on another path: restorative approaches in healthcare. Drawing on developments across New Zealand, Australia, Canada, England, and the United States, the authors show how restorative initiatives are reshaping safety culture by centering dignity, equity, and healing .
Restorative responses are grounded in simple but radical questions:
- Who has been harmed?
- What are their needs?
- Whose responsibility is it to meet those needs?
This isn’t about erasing accountability. Removing blame actually increases accountability—not in the narrow sense of punishing individuals, but in the broader responsibility to learn, repair, and change systems so harm is less likely to happen again. Forward-looking accountability asks: what must we do differently to create safer, more humane care ?
Evidence is emerging that when done well, restorative responses reduce trauma, improve trust, and generate stronger lessons for safety improvement .
Key enablers identified include:
- Indigenous leadership and worldviews shaping how harm is understood and repaired.
- Mental health services leading the way, where trauma-informed, dialogical practices align closely with restorative principles.
- Policies that move beyond “as few things as possible go wrong” (Safety-I) to “as many things as possible go right” (Safety-II) .
The message is clear: healing and learning are not separate tasks—they belong together.
For schools, hospitals, and community services exploring how to handle harm with humanity, the lessons from this international collaboration are profound. Restorative systems don’t remove accountability. They deepen it—asking leaders, teams, and systems to step up, take responsibility, and turn pain into progress.