The National Institute of Justice has partnered with the Bureau of Justice Assistance and the Quattrone Center for the Fair Administration of Justice to empower local communities to conduct collaborative reviews of justice system failings, with the goal of understanding system causes, mitigating risk, and preventing reoccurrence of negative outcomes at the local level.
Learning From Error in Criminal Justice
When bad things happen in criminal justice systems, they are rarely the result of a single actor, action, or decision, and are often indicative of a system weakness. However, most jurisdictions review errors solely through a lens of blame, looking for individual practitioners to punish. This blame-oriented approach ignores the multiple system causes that contributed to the bad outcome and remain in place to contribute to another, similar event in the future.
NIJ believes that local jurisdictions should have the opportunity to learn from mistakes and “near miss” events, and prevent the recurrence of errors and bad outcomes. To that end, NIJ’s Sentinel Events Initiative (SEI) is exploring the value of sentinel event reviews in which all individuals whose actions or inactions may have contributed to an event are empowered to develop solutions to prevent future bad outcomes. Through these all-stakeholder, non-blaming, forward-looking reviews, law enforcement officers, prosecutors, judges, forensic scientists, communities, persons harmed, and others come together to conduct a review of a bad outcome and develop recommendations for improving criminal justice.
National Demonstration Collaborations
After years of funded research, stakeholder forums, field input and support, and lessons learned from pilot projects, NIJ is partnering with the Bureau of Justice Assistance and the Quattrone Center for the Fair Administration of Justice on a series of national demonstration collaborations to build local capacity to implement standing sentinel event review panels in jurisdictions across the country. These reviews will be locally driven, with each site determining the process, cases to review, and desired outcomes they will pursue. It is our belief that in better understanding the multiple causes of bad outcomes, these review teams will generate solutions that result in system improvement and error reduction. This approach transforms bad events into opportunities for jurisdictions to address systemic flaws, prevent their recurrence, and earn public trust.
This project reflects the input of numerous criminal justice practitioners, policymakers, academics, and communities, and NIJ is deeply grateful for the wisdom and experience that has been shared throughout this process. NIJ thanks the actors who have contributed for all they have done to advance our shared mission, and looks forward to continued collaborations as this program develops.