Related Experiment Video
Updated: May 30, 2026

Pavlovian Conditioned Approach Training in Rats
Published on: February 4, 2016
Improving RCA performance: the Cornerstone Award and the power of positive reinforcement
James P Bagian1, Beth J King, Peter D Mills
1University of Michigan Medical School and College of Engineering, Ann Arbor, MI, USA.
Background:
The Veterans Health Administration has had a comprehensive patient safety program since 1999 that includes conducting root cause analysis (RCA) of adverse medical events. Improving the quality and timeliness of the RCAs at the local level has been a continual challenge.
Methods:
We initiated a non-monetary program called the Cornerstone Award into our patient safety reporting system to recognise facilities conducting high-quality and timely RCAs containing deterministic corrective actions that are implemented and evaluated for effectiveness.
Results:
Since the Cornerstone Program began in 2008, the per cent of RCAs completed in a time-critical manner (≤45 days) has increased from an average of 52% pre-Cornerstone to an average of 94% post-Cornerstone. The per cent of action plans with stronger deterministic actions and outcomes has increased from an average of 34% pre-Cornerstone to an average of 70% post-Cornerstone.
Discussion:
Implementing a non-monetary recognition award that was tied to specific improvement goals greatly improved the timeliness and quality of the RCA reports in the Veterans Health Administration System.
Related Concept Videos
Reinforcement
Positive reinforcement occurs when a behavior is followed by the presentation of a rewarding stimulus, increasing the frequency of that behavior. For example:
Operant Conditioning
Reinforcement in operant conditioning can be positive or negative, both of which serve to increase the likelihood of a behavior. Positive...
Primary and Secondary Reinforcers
Effective reinforcers for humans vary depending on the individual and the context. Primary reinforcers, such as food, water, sleep, shelter, and pleasure, have inherent value and satisfy basic biological...
Behavior Modification
A real-world application of operant conditioning principles is applied...
Operant Conditioning Intervention
In operant conditioning, behaviors that are...
Behaviorism
The core premise of behaviorism is its focus on observable behavior rather than internal thoughts or feelings. This approach argues that true scientific...
