After an adverse event, prompt and honest communication with the patient and family members has become the best practice in healthcare over the past decade, and the federal government is supporting that effort with a new toolkit from the Agency for Healthcare Research and Quality (AHRQ).
The Communication and Optimal Resolution (CANDOR) Toolkit provides a process that healthcare institutions and practitioners can use to respond when unexpected events cause patient harm. The toolkit is based on expert input and lessons learned from AHRQ’s $23 million Patient Safety and Medical Liability grant initiative launched in 2009. The CANDOR Toolkit was tested and applied in 14 hospitals across three healthcare systems in the United States.
The CANDOR Toolkit contains eight modules, each containing slides with facilitator notes. Some modules also contain tools, resources, or videos. Generally, the CANDOR process begins with identification of an event that involves harm. This step activates initiation of coordinated post-event processes.
The CANDOR Toolkit is intended to help hospitals save money on malpractice litigation while encouraging more robust scrutiny of what went wrong and a full disclosure to the patient or family. In addition to supporting patients’ families, CANDOR also acknowledges that an adverse event can be traumatic for clinicians and provides ways to assist them.
CANDOR calls for a prompt response after an adverse event, with specific actions to take. When a case involving patient harm is identified, trained hospital staff members tell victims or their families what happened within one hour. They also contact the clinicians involved and offer assistance. The hospital also puts an immediate hold on the billing process so the patient or family is not stressed by a bill for the very services that may have injured or killed the patient. Hospital leaders stay in touch with patients and relatives during the investigation, which should be completed within two months. The results of the investigation are shared with the patient or family, along with a discussion of how to prevent such adverse events in the future.
When the investigation concludes that harm resulted from a breach in the standard of care, CANDOR calls for the hospital to negotiate financial compensation.
The CANDOR Toolkit is available online for readers at http://1.usa.gov/1P2A17C.