Question 1
Was there a policy or process to manage this risk?
Question 2
Was the policy or process followed?
Question 3
Are there established procedures, processes, or structures to manage this risk that were not followed?
Question 4
Does a policy, procedure, process or structure need to be developed?
Question 5
Was the policy / process flawed, inadequate, or difficult to follow — OR did the employee lack understanding of it?
Question 6
Did the employee's action or inaction contribute to the error?
Question 7
Were the actions of the employee intended to deliberately harm the patient or employee?
Question 8
Did the employee conceal the error or falsify the record?
Question 9
Did the employee consciously take a substantial risk or demonstrate intentional disregard for the policy / process?
Question 10
Is there a history of other similar or serious errors by this employee?
Question 11
Could a reasonably prudent employee have done the same in similar circumstances?
Question 12
Did the employee previously receive remediation or counseling for a similar error?
Question 13
Were mitigating factors present that the organization accepts as justifiable?
Question 14
Did the employee's actions or inaction ALSO contribute to the error (shared accountability with the system flaw)?
Algorithm Result
✅
No Further Action Required
Final Step
Leader Sign-Off
Enter your Employee ID to auto-fill your name, then confirm the date before submitting.
