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Before you start

Before the analytic work begins, be sure your organization has taken these three steps.

  • Stabilize the situation

    Be sure the patient involved in the event is well-cared for, make the situation safe for others, and sequester equipment, products, or materials if warranted.

  • Determine if RCA² is the right tool for the event that occurred

    Use this safety assessment code matrix to help determine if the event or risk identified is best analyzed using RCA2. If you are using the matrix to prioritize among several events or near misses for analysis, one person in your organization should be assigned responsibility for applying the matrix to events to be sure it's applied consistently.

  • Secure leadership's support

    Your facility’s leadership plays a significant role in the success of RCA2 work.

    • Leadership (such as CEO, board of directors, etc.) should be actively involved in the root cause analyses and actions process. Leadership should be accountable for supporting the process, approving and periodically reviewing the status of actions, understanding what a thorough RCA2 report should include, and acting when reviews do not meet minimum requirements.
    • Leadership should review the RCA2 process for effectiveness at least annually.