Editor's note: This feature explores problematic Joint Commission standards with expert advice from BOJ advisors. This month, Elizabeth Di Giacomo-Geffers, RN, MPH, CNAA, BC, a healthcare consultant in Trabuco Canyon, CA, discusses PI.3.20. PI.3.20 requires an ongoing and proactive process for seeking out the causes of-and identifying methods for the prevention of-adverse effects to increase patient safety. PI.3.20 applies preventive, proactive patient safety tactics rather than reactive actions taken only after an error or adverse event has occurred.