Pt. Safety Risk

The Three Behaviors

ABC model of attitudes

This involves a person’s feelings / emotions about the attitude object. For example: “I am scared of spiders”.

The way the attitude we have influences how we act or behave. For example: “I will avoid spiders and scream if I see one”.

This involves a person’s belief / knowledge about an attitude object. For example: “I believe spiders are dangerous”.

The Three Behaviors

an inadvertent action; inadvertently doing other than what should have been done; slip, lapse, mistake.

a behavioral choice that increases risk where risk is not recognized or is mistakenly believed to be justified

 (Intolerable behavior) a behavioral choice to consciously disregard a substantial and unjustifiable risk.

Three categories of behavior are: human errors, at-risk behaviors, and reckless behaviors.

Human errors: are entirely unintentional and usually due to environmental issues, poor processes, programs, education, or situations.

These are managed by correcting the cause like changes in environment, design,  looking at the process, and fixing the deviation—not the human.

Example: Look-Alike Sound-Alike Medications

At-risk behaviors: Accepting a known risk for overriding reasons or lack of awareness of a known risk , occur when it’s easier to make the wrong choice. (Intentional action but unintended outcome).

These are managed by removing incentives for risky behaviors, creating incentives for healthy behaviors and increasing situational awareness.

Example: a checklist is not used before a procedure to save time  (perceived as unnecessary).

Reckless behaviors: are conscious decisions to put your self or others at risk (Intentional action with a probable outcome, though not desired).

These are managed by: discipline and punishment

Example: disregarding inaccurate sponge/instrument count in surgery (self-assured of accuracy).

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Dr. Khalid Abulmajd

Healthcare Quality Consultant

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