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Center for Open, Honest Communication

Our Mission

The MIQS Center for Open and Honest Communication in Healthcare is dedicated to the mission of improving communication between patients, their caregivers, and the healthcare system along the continuum of care. From the hospital, to primary and specialty care, the Center for Open and Honest Communication in Health is a leader in supporting clinicians and healthcare staff to develop deep, meaningful relationships with their patients and families through open, honest, and clear communication.

We know that medical error is the third leading cause of death in the United States, and the number one cause of medical error is communication. Despite our awareness, health systems are not improving at the rate the public deserves. One reason is the traditional “delay, deny and defend” approach to risk management, which lies in direct opposition of learning and system improvement cultures that are the foundation of health systems delivering the safest, highest quality care. A CANDOR (Communication AND Optimal Resolution) approach to managing medical error changes the focus and allows for a new, innovative approach that not only protects our patients and families, but also our caregivers and our health systems as well. This is a patient safety program that addresses the liability concerns of all involved, while at the same time engendering a learning environment and a culture of safety that allows health systems to do the right thing. We are accountable, while at the same time able to fix our systems, engaging the legal system only when necessary. All at the right time. For the right reasons.

The CANDOR approach, now also an AHRQ Tool Kit, lays out tested, systematic strategies for improving communication with patients and families after harm occurs whether preventable or not, and allows for the learning and system improvements that ensure the same harm will be avoided in the future. Communication and Resolution Programs, like CANDOR, that support early communication with patients and support for providers have been shown to improve patient safety, reduce medical liability, and sustain relationships between patients, families, provider organizations and staff. In addition, the team at the MedStar Institute for Quality and Safety has embedded a structured and robust approach to each event review, and has operationalized caring for our caregivers, all initiated within minutes of any event.

We are eager to serve as leaders and collaborators in this work. Many of our MIQS team members have been involved in every iteration of the principles that define CANDOR since the formal research and work began in 2004. Our team has been committed to this work for the majority of their careers as clinicians, researchers, and healthcare leaders. Come learn with us.


Learn about CANDOR, a way to zero preventable harm while maintaining trust and support of patients, families and care teams. CANDOR is an AHRQ Tool Kit and program that teaches the “how to” and value of open, honest Communication and Optimal Resolution in the face of patient harm.


What Others Are Saying

Barbara 1

CANDOR benefits patients and families because they can learn early on when something unexpected occurs to find out what we're doing and what they know can contribute to the event review...It's absolutely the right thing to do; when something doesn't go well in healthcare we have to figure it out. We can't wait. We want to do what's right for the patient at the time of the event.

- Barbara Pelletreau, SVP, Patient Safety Dignity Health

Barbara 2

CANDOR is really a way for Dignity Health to take some of the basics--root cause analysis, event investigation, disclosure, across 40 hospitals to higher level that's more patient- and clinician-centric. It aligns with our values, our mission and who we are.

- Barbara Pelletreau, SVP, Patient Safety Dignity Health

Patel 2

CANDOR is the best thing we can do for our patients. They trust us to do the right thing, and we don't want to break that trust. The only way you can do that is to be open, honest and transparent. CANDOR is exactly that.

- Dr. Patel, MD VP Medical Affairs, Quality & Safety Dignity Health East Valley