Combination of the UK model and the outcome engineering model
Allen Frankel and Michael Leonard propose a combination of the two models, with some simple questions to help investigators walk through the possibilities:
Was the individual knowingly impaired? Did the individual consciously decide to engage in an unsafe act? Did the caregiver make a mistake that individuals of similar training would be likely to make under the same circumstances (substitution test)? And does the individual have a history of unsafe acts? This short list of questions provides a clear model of accountability and also tells providers “what the rules are,” so they can feel safe to speak up, facilitating ongoing education and improvement.