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A Regulatory Model/Decision Tree for Collaboration and Practice Accountability Maryann Alexander, PhD, RN Nancy Spector, PhD, RN Maureen Cahill, MS, RN.

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Presentation on theme: "A Regulatory Model/Decision Tree for Collaboration and Practice Accountability Maryann Alexander, PhD, RN Nancy Spector, PhD, RN Maureen Cahill, MS, RN."— Presentation transcript:

1 A Regulatory Model/Decision Tree for Collaboration and Practice Accountability Maryann Alexander, PhD, RN Nancy Spector, PhD, RN Maureen Cahill, MS, RN Kathy Russell, JD, RN

2 © 2012 The Just Culture Model (simplified) Reckless Behavior Conscious Disregard of Substantial and Unjustifiable Risk Manage through: Remedial action Punitive action At-Risk Behavior A Choice: Risk Believed Insignificant or Justified Manage through: Removing incentives for at-risk behaviors Creating incentives for healthy behaviors Increasing situational awareness Human Error Product of Our Current System Design and Behavioral Choices Manage through changes in: Choices Processes Procedures Training Design Environment ConsoleCoachPunish

3 A Single Event Repetitive Events Repetitive errors – yes, there is a process Repetitive at-risk behaviors – yes, there is a process Both may lead to disciplinary action… The Just Culture Model

4 Just Culture Examines the fallibility of the system as well as inevitable human error and flawed behavioral choices System Human Error Flawed decisions

5 Regulation Public Protection Holding systems and individuals accountable for their actions Safer care for Patients

6 Regulatory Model – Encourage reporting of errors so that systems, processes and behaviors can be improved – Collaborative/Partnership (Facility and BON and Nurse and Facility) – Centers around the patient – Focus is on ethical behavior – Encourages remediation – Employs discipline where needed

7 Accountability of Nurse Recognize Contributions of System Errors Patient Outcome Not Primary to BON Decision Boards and Employers Collaborate Use Reliable Tools to Evaluate Behaviors and Systems

8 Regulatory Decision Model

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11 Next Steps Volunteers Try out the decision tree Send us your feedback/comments Feedback from Outcomengenuity Develop a resource kit Pilot the model/algorithm once completed

12 Our Goal Help BONs make consistent decisions that protect the public and lead to safer systems and competent practitioners.


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