The introductory article on Predictability Lead Time™ has been syndicated across more than 300 news and media websites, including USA Today, AP News, Business Insider Markets, Benzinga and StreetInsider.
Violence Against Healthcare Workers Remains a Persistent Challenge
What If We're Asking
The Wrong Question?
Predictability Lead Time™
A new framework for measuring the earliest point at which violence against healthcare workers could reasonably have been recognized as becoming predictable.
Despite decades of policies, reporting systems, staff education, incident investigations, and prevention initiatives, violence against healthcare workers continues to occur across healthcare settings around the world.
Healthcare has faced seemingly intractable challenges before.
Patient safety demonstrated that changing how healthcare thinks can dramatically change outcomes.
Predictability Lead Time™ (©2026) asks whether another shift in thinking could advance our understanding of when violence against healthcare workers becomes reasonably predictable.
Why This Matters
Patient safety did not transform healthcare because organizations simply investigated more incidents. It transformed healthcare because the profession began asking different questions. That shift led to new ways of understanding systems, communication, risk, and preventable harm.
Today, violence against healthcare workers remains one of healthcare's most persistent safety challenges.
Predictability Lead Time™ explores whether asking a different question might reveal opportunities that existing approaches have not yet identified.
"The measure of a healthcare system is not only how well it protects its patients,
but how unwilling it is to accept predictable harm to the people who care for them."
Alison Prentice
Founder, Predictability Institute™
"that's just how it is"
The Story Behind the Question
Predictability Lead Time™ began with a question that stayed with me throughout my nursing and healthcare leadership career:
When could an event reasonably have been recognized as becoming predictable?
The question crystallized after I heard the events leading up to a nurse being seriously injured at work. As the story unfolded, it became difficult to ignore how many warning signs had accumulated before the assault occurred. Staff knew the risks. Management knew the risks. Everyone was waiting for a longer-term solution.
After the nurse suffered two broken ribs in two months, concerns were raised. The response was simple:
"That's just how it is."
That moment changed how I thought about violence against healthcare workers. Rather than asking only why an incident occurred, I began asking whether there was an earlier point at which the developing situation could reasonably have been recognized as becoming predictable.
That question became the foundation for Predictability Lead Time™.
RECOGNIZING WHEN VIOLENCE BECOMES REASONABLY PREDICTABLE
A Different Way to Think About violence against healthcare workers
Most investigations into violence against healthcare workers begin by asking why an incident occurred.
Predictability Lead Time™ begins with a different question:
When could this event reasonably have been recognized as becoming predictable?
That subtle shift changes the analytical perspective. Instead of beginning with why violence occurred, it begins by examining how predictability may have developed before harm took place. It is a different way of thinking about violence against healthcare workers, founded on a different question.
Asking a different question naturally leads to examining different aspects of an event.
The framework is intended to provide a structured methodology for examining:
How situations evolve over time.
How warning patterns accumulate rather than exist in isolation.
How organizational knowledge develops before an incident occurs.
Where opportunities for earlier recognition may have existed.
How predictability changes as circumstances unfold.
The methodology is designed to complement existing investigation processes rather than replace them.
ASK A DIFFERENT QUESTION
Move beyond "Why did this happen?" to explore "When did this become predictable?"
THINK DIFFERENTLY ABOUT PREDICTABILITY
Apply a structured analytical framework to examine how predictability may have developed before violence occurred.
CREATE DIFFERENT OPPORTUNITIES
Recognize opportunities for earlier action, stronger organizational learning, and better-informed prevention strategies.
Patient safety demonstrated that changing how healthcare thinks can dramatically change outcomes. Could another shift in thinking advance our understanding of other forms of predictable harm?
Where Could a Different Way of Thinking Lead Next?
Healthcare has changed how it thinks before.
Patient safety demonstrated that asking different questions and recognizing predictable harm earlier could transform outcomes.
Predictability Lead Time™ explores whether that same analytical perspective may have value wherever harm develops over time and opportunities for earlier recognition may exist.
Potential areas for future exploration include:
Clinical Risk Management
Communication Failures
Diagnostic Delay
Organizational Learning
The Methodology
Built Around a Structured Assessment Methodology
Predictability Lead Time™ is more than a single concept or question. It is a structured analytical framework designed to support consistent assessment of how predictability may develop before violence against healthcare workers occurs.
The framework brings together several integrated components that work together to support a systematic approach to analysis.
Core Framework
• Predictability Lead Time™
• Predictability Lead Time Index™
Assessment Methodology
• Predictability Window™
• Predictability Confidence Indicator™
Framework Implementation
• Predictability Maturity Model™
• Predictability Assessment Lifecycle™
The complete framework is introduced in the Concept Overview and described in greater detail throughout the Executive Overview and Validation Package.
Building Interest Before Implementation
Who We're Inviting to Explore Predictability Lead Time™
Predictability Lead Time™ is being introduced to healthcare professionals, researchers, academic institutions, and potential strategic partners interested in exploring whether this different analytical perspective may contribute to a better understanding of violence against healthcare workers.
The immediate objective is not implementation.
It is to encourage professional discussion, independent evaluation, and collaboration around a new way of thinking about predictable violence.
The immediate objective is straightforward.
Determine whether this different way of thinking warrants further professional evaluation, collaboration, research, software development, and future implementation.
Professional interest comes first. Evidence follows.
Healthcare Leaders
Explore whether Predictability Lead Time™ offers a different way of understanding and learning from violence against healthcare workers.
Quality Improvement Specialists
Evaluate how a different analytical perspective may complement existing quality improvement methodologies.
Risk Management Professionals
Examine how earlier recognition of predictable harm may strengthen organizational risk assessment.
Researchers
Evaluate, challenge, refine, or validate the framework through independent research and scholarly investigation.
Academic Institutions
Explore opportunities for collaborative research, scholarly discussion, curriculum development, and future educational applications.
Health Informatics Organizations
Explore how structured predictability assessment could inform future healthcare information systems and analytical tools.
Potential Commercialization Partners
Explore opportunities to responsibly develop and commercialize Predictability Lead Time™ following professional evaluation and growing evidence.
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
Start the Conversation
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