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About Predictability Institute™
Advancing New Thinking About Predictable Harm
Predictability Institute™ was established to develop, steward, and advance Predictability Lead Time™, an emerging analytical framework that explores whether harmful events may become recognizable as predictable earlier than traditional investigations often examine.
The Institute exists to encourage professional discussion, independent evaluation, collaboration, and future research surrounding the framework. Its role is not to advocate predetermined conclusions, but to promote thoughtful examination of a different analytical question.
As interest grows, the Institute intends to support ongoing refinement of the framework through engagement with healthcare leaders, researchers, quality improvement professionals, risk managers, and other disciplines interested in understanding predictable harm.
"When could an event reasonably have been recognized as becoming predictable?"
The Story Behind the Question
Predictability Lead Time™ grew from a question I returned to repeatedly throughout my nursing and healthcare leadership career:
When could an event reasonably have been recognized as becoming predictable?
The question crystallized after the family member of a nurse described the events preceding an incident of violence at work. As the story unfolded, it became difficult to ignore how many opportunities there may have been to recognize that the risk was increasing.
The nurse planned to reduce her full-time position because she was tired of being injured at work. One resident under her care had experienced repeated psychotic episodes. Staff knew there was a risk. Management knew there was a risk. Everyone was waiting for the resident to be transferred to a more appropriate facility. In the meantime, staff were expected to keep working.
The nurse suffered two broken ribs in two months. When concerns were raised, the response was simple:
“That’s just how it is.”
That sentence should concern every healthcare leader. Violence against healthcare workers is not new, but somewhere along the way, known and increasing danger became accepted as part of normal operations.
The incident also reflected a broader pattern. Violence is often followed by an incident report, a debrief, and support for the injured worker. Those responses matter, but they usually begin after the harm has occurred. They do not always examine the earlier period during which warning signs may have accumulated, organizational awareness may have developed, and the situation may have become reasonably recognizable as predictable.
Predictability Lead Time™ grew from the belief that this earlier period deserves closer examination.
The methodology doesn't begin by asking who should have predicted an individual act of violence. It asks a different question:
When could a developing situation reasonably have been recognized as becoming predictable?
It is this pattern, organizations absorbing known and increasing harm as routine rather than examining it as a systems concern, that led me to develop Predictability Lead Time™.
Our Mission
To advance analytical approaches that help professionals identify opportunities to recognize predictable harm earlier, support informed discussion, and encourage evidence-based evaluation of emerging ideas.
Our vision
A future in which organizations routinely examine not only why harmful events occurred, but also when they may first have become reasonably recognizable as predictable.
This application (violence against healthcare workers) has been selected because workplace violence remains a
significant challenge internationally despite extensive investigation, policy development, and prevention efforts.
The framework explores whether examining the point at which escalating situations first became
reasonably predictable may contribute an additional perspective alongside existing approaches.
Future exploration may examine other forms of predictable harm where similar analytical questions could prove valuable.
Founder
Alison Prentice, BsCN
Former Director of Nursing
Founder of Predictability Institute™
Alison Prentice developed Predictability Lead Time™ after decades of observing how healthcare investigates harm, manages risk, and improve safety within healthcare organizations. Her work asks whether meaningful opportunities to recognize predictable harm may exist earlier than traditional investigations often examine, shifting the discussion from only asking why harm occurred to also asking when it first became reasonably recognizable as predictable.
Predictability Institute™ was established to provide an independent home for the continued development, professional evaluation, and responsible stewardship of the framework. Through the Institute, Alison is encouraging discussion, collaboration, independent review, and future research to determine where Predictability Lead Time™ may contribute practical value.
A Framework Built for Collaboration
Predictability Lead Time™ is presented as an invitation to professional discussion.
The Institute welcomes interest from healthcare organizations, researchers, academic institutions, quality improvement professionals, risk management leaders, and potential research collaborators who wish to explore the framework further.
learn more
The Predictability Lead Time™ Introduction Series has been developed to
introduce the framework in progressively greater detail. Documents are provided progressively as part of the professional introduction process.
REQUEST THE FIRST IN THE SERIES BELOW
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Ready to Explore a Different Way of Thinking?
If this concept is relevant to your work, request the first document in the Predictability Lead Time™ Introduction Series below.
PRIVACY
Your information will be used only to provide access to this publication and to notify you of significant future publications and developments related to Predictability Lead Time™. Your information will not be sold or shared with third parties.
Patient safety changed healthcare by changing how healthcare thought about harm. Predictability Lead Time™ begins by asking whether violence against healthcare workers deserves the same willingness to think differently.
Predictability Institute™ advances new ways to understand and measure predictable harm in healthcare through research, structured assessment methodologies, and professional collaboration.
© 2026 Predictability Institute™. All rights reserved. Predictability Institute™, Predictability Lead Time™, Predictability Lead Time Index™, Predictability Window™, Predictability Marker™, Predictability Timeline™, Organizational Awareness Timeline™, Organizational Awareness Interval™, Response Interval™, Intervention Interval™, Predictability Confidence Indicator™, Predictability Maturity Model™, Predictability Assessment Lifecycle™, and Organizational Acceptance of Predictable Harm™ are trademarks of Alison Prentice.
© 2026 Predictability Institute™ . All rights reserved