Which of the following is an example of a leading indicator in quality improvement?

• A. Employee satisfaction score
• B. Number of safety observations
• C. Past audit findings
• D. Incident rate

Answer: (B)

Leading indicators are measurements that reflect proactive actions or inputs that predict future performance. The number of safety observations fits this idea because it captures how often people are actively checking conditions, identifying hazards, and taking corrective steps before harm occurs. When this metric increases, it signals a more vigilant safety culture and more opportunities to prevent incidents, which helps forecast a future drop in incident rates.

In contrast, incident rate shows actual injuries that have already occurred, so it’s a lagging indicator. Past audit findings reveal issues identified historically rather than current proactive actions. Employee satisfaction reflects morale and engagement which can influence behavior, but it does not directly measure the ongoing proactive safety actions in the workflow as clearly as safety observations do.