Training, by itself, points to a deficiency in your program.
If you couple training with an assessment and/or some revision of your ongoing program to prevent this deficiency from occurring again, then it should be a viable option.
You need to look beyond this single incident and see why it was allowed to begin with.
When we push back on training as a CA, it is often because we have seen a repeat occurrence of the deviation elsewhere, or see the risk of a repeat when there is not an additional change implemented to the system.
The Department of Veterans Affairs National Center for Patient Safety’s Hierarchy of Actions2 classifies corrective actions as:
Weak: Actions that depend on staff to remember their training or what is written in the policy. Weak actions enhance or enforce existing processes. Examples of weak actions: •• double checks •• warnings/labels •• new policies/procedures/memoranda •• training/education •• additional study
Intermediate: Actions are somewhat dependent on staff remembering to do the right thing, but they provide tools to help staff to remember or to promote clear communication.
Intermediate actions modify existing processes. Examples of intermediate actions: •• decrease workload •• software enhancements/modifications •• eliminate/reduce distraction •• checklists/cognitive aids/triggers/prompts
Strong: Actions that do not depend on staff to remember to do the right thing. The action may not totally eliminate the vulnerability but provides strong controls. Strong actions change or re-design the process. They help detect and warn so there is an opportunity to correct before the error reaches the patient. They may involve hard stops which won’t allow the process to continue unless something is corrected or gives the chance to intervene to prevent significant harm. Examples of strong actions: •• physical changes: grab bars, non slip strips on tubs/showers •• forcing functions or constraints: design of gas lines so that only oxygen can be connected to oxygen lines; electronic medical records – cannot continue charting unless all fields are filled in •• simplifying: unit dose
Training is not an assignable cause of the corrective action process.
The management responsibility is to ensure a system of check and balances is in place in the effective training process.
I think training gets a bad rap as a corrective action not because it can't address the root cause of the issue, but because it's been too often applied when in fact a lack of training was not the root cause of the problem. In other words, the mass of people who sloppily completed 8D's have tainted the tremendous value of training as a corrective activity. (Maybe it's a lack of training in 5-Why Analysis??) In effect, it seems like a bunch of quality professionals "threw the baby out with the bath water" when they decided that training can't be a stand alone corrective action.
Nonetheless, like so many others, I rarely list "training" of any kind as a stand alone corrective action, but instead I use it widely to supplement other, more tangible activities.
And now for a shameless plug: I do teach a 9-hour long online class titled "Root Cause Analysis and the 8D Corrective Action Process". In it I address a wide range of tools and concepts related to RCA and corrective actions including "softer" tools like training and quality alerts. ASQ members signing up with the link below will get lifetime access to the entire class for $13.99. The coupon is valid for the next 30 days.
Thanks again for the excellent question ... I hope you found the range of opinions you were seeking.
Training can be part of a corrective action, after performing a root cause.
The thing is employees sometimes experience this as a way of punishing them for doing something wrong.
Has to do with the organizational culture.
But why wait till something happens to dig in deeper, to find out that someone or the whole team needs
Planning yearly training and measuring the effect of the training, will have positive value for the team, and the organization. Human
errors can still happen when we plan regular training, but it will decrease.
My concern is that measuring the effectiveness of training has always been NEGLECTED.
Great topic Joe