The Patient Safety Movement Foundation (PSMF) recommends that healthcare organizations around the world implement the Communication and Optimal Resolution (CANDOR) online toolkit published by the Agency for Healthcare Research and Quality (AHRQ). AHRQ selected MedStar to develop and pilot the toolkit for the CANDOR program. The online toolkit can help organizations create a culture of safety that focuses on organizational accountability; caring for the patient, family, and caregiver; in-depth event investigation and analysis; fair resolution when harm occurs; and learning from every harm event
MedStar Health, the largest health system in the mid-Atlantic region, has been a committed member of the Patient Safety Movement since 2013. MedStar was selected to help develop and pilot the toolkit for the CANDOR program because of its system-wide commitment to achieving zero preventable harm. MedStar is an example of a healthcare system that embraces transparency and is adopting practices to immediately communicate with patients and families when serious unanticipated outcomes occur. In addition to MedStar, the CANDOR process was implemented and tested at Christiana Care in Delaware and Dignity Health in California.
The CANDOR process was based off the Seven Pillars program developed at the University of Illinois, Chicago, also supported by a 2010 AHRQ demonstration grant, part of the Obama Administration’s commitment to reducing both preventable harm in healthcare and medical liability claims. The CANDOR online toolkit provides a framework to assess readiness, get buy-in from key stakeholders including liability insurers, and expedite supportive, time sensitive responses to unexpected patient harm events.
The toolkit is available to hospitals and health leaders at no charge. Hospitals that have implemented CANDOR have seen improved patient safety outcomes, improved patient satisfaction scores by engaging patients and families throughout the CANDOR process and have experienced a reduction in medical liability claims. Hospitals involved in the 2010 AHRQ demonstration grants demonstrated the following results:
- 40 percent reduction in preventable medical harm events
- 40 percent decline in the number of malpractice claims
- 80 percent decrease in self-insured fund set-aside ($40 million to $8 million)
- 80 percent reduction in time to settle cases
- 20 percent reduction in services associated with defensive medicine
“The Patient Safety Movement Foundation recognized the significance of this work from day one and we appreciate their continued support in helping us educate the healthcare community on the benefits of CANDOR. Dealing with unintentional patient harm transparently and forthrightly is not only the right thing to do but is also critical to our ability to learn and make improvements to our care systems and processes,” said David Mayer, MD, MedStar Vice President for Quality and Safety. “Since MedStar Health began using CANDOR principles as a key component of its safety program, the health system has seen its rate of serious safety events cut in half. Even with this significant progress, MedStar Health will not be satisfied until we have achieved zero preventable harm.”
“We are extremely grateful and proud of the work Dr. Mayer and MedStar Health are doing in collaboration with the Agency for Healthcare Research and Quality,” said Joe Kiani, Founder of the Patient Safety Movement Foundation. “The unfortunate truth is that at many health institutions, a ‘wall of silence’ goes up whenever a patient is harmed during care. By promoting a culture of open communication, empathy and transparency, CANDOR processes will not only help patients and their families get through an agonizing tragedy, but ultimately lead to fewer preventable deaths by revealing and reporting how these deaths occur. CANDOR is a vital step toward our goal of zero preventable deaths by 2020.”