Kaplan’s Decision Tree: A 3-Step Process for Safe Clinical Judgment

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

OR

Priority Question Evaluation Question

Priority Action Priority Client Alternate Strategies Scope of Practice Therapeutic Communication

• Assessment vs. • Stable vs. Unstable
Implementation
• Expected vs. Unexpected
• Physical vs. Psychosocial
• ABCs
• ABCs
• Acute vs. Chronic
• Actual vs. Potential
• Right/Wrong, True/False
• Indicated/Contraindicated
• Expected/Unexpected
• Normal/Abnormal
• If/Then
• Infectious/Non-infectious
RN - Cannot delegate
assessment or initial teaching
LPN/LVN - Stable client with
predictable outcome
UAP - Standard, unchanging
procedures
Do:
• Respond in feeling tone,
provide information, focus,
use silence and presence
• Use reflection or
open-ended questions
Don’t:
Ask why, ask yes/no, say
“don’t worry”

• Tally risk factors

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?
 Kaplan’s Decision Tree:
A 3-Step Process for Safe Clinical Judgment

Priority Action Branch

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

Priority Question

Priority Action

• Assessment vs. Implementation

• Physical vs. Psychosocial

• ABCs

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?
 Kaplan’s Decision Tree:
A 3-Step Process for Safe Clinical Judgment

Priority Client Branch

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

Priority Question

Priority Client

• Stable vs. Unstable

• Expected vs. Unexpected

• ABCs

• Acute vs. Chronic

• Actual vs. Potential

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?
 Kaplan’s Decision Tree:
A 3-Step Process for Safe Clinical Judgment

Alternate Strategies Branch

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

Evaluation Question

Alternate Strategies

• Right/Wrong, True/False

• Indicated/Contraindicated

• Expected/Unexpected

• Normal/Abnormal

• If/Then

• Infectious/Non-infectious

• Tally risk factors

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?
 Kaplan’s Decision Tree:
A 3-Step Process for Safe Clinical Judgment

Scope of Practice Branch

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

Evaluation Question

Scope of Practice

RN - Cannot delegate assessment or initial teaching

LPN/LVN - Stable client with predictable outcome

UAP - Standard, unchanging procedures

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?
 Kaplan’s Decision Tree:
A 3-Step Process for Safe Clinical Judgment

Therapeutic Communication Branch

STEP 1: Topic
Make a content connection

STEP 2: Strategy
Strategies, tips, and key principles to assist in elimination

Evaluation Question

Therapeutic Communication

Do:
• Respond in feeling tone, provide information,
focus, use silence and presence

• Use reflection or open-ended questions

Don’t:
Ask why, ask yes/no, say “don’t worry”

STEP 3: Outcome
Does your answer match your topic? Is it desired? Does it promote safety?