What is CANDOR
CANDOR (Communication and Optimal Resolution) is a foundational element of the comprehensive patient safety program at MedStar Health. CANDOR, along with a commitment to fostering a learning culture, the principles of high reliability organizations, and a systems approach to identifying, examining, and resolving weaknesses in our system are hallmarks of the MedStar safety program. CANDOR itself is a paradigm shift from “delay, deny and defend” to early communication with patients and families leading to timely resolution and systems improvements where appropriate.
Unexpected patient harm is far too common, and the response typically fails to meet the patient’s and family’s needs, or promotes learning that could prevent future harm. Communication and Resolution Programs (CRPs), like CANDOR, are a principled approach for responding to patient harm. They are an integral component of an effective, empathic patient safety and quality improvement program, implemented for the benefit of patients, care professionals and our healthcare communities.
Driven by the transformative policies of President Barack Obama, a new CRP resource, the CANDOR (Communication and Optimal Resolution) Toolkit, was recently published by the Agency for Healthcare Research and Quality (AHRQ). MedStar Health was a leader in the development and testing of the CANDOR Toolkit, and was selected as the largest CANDOR pilot site because of its demonstrated commitment to open and honest communication with patients and families when serious, unanticipated outcomes occur. MedStar has fostered a culture of transparency throughout every patient interaction, relying on a just culture and a state-of-the-art event review process engineered by human factors experts to learn from every event. These same cultural tenets are the basis of MedStar’s high reliability journey, and this foundation was intentionally built in order to achieve the system-wide goal of zero preventable harm.
The CANDOR program bridges the Patient Safety – Medical Liability Chasm. MIQS faculty co-developed the AHRQ CANDOR toolkit largely based upon their work performed at the University of Illinois Hospital and Health Sciences System published under, Seven Pillars Approach to Crossing the Patient Safety – Medical Liability Chasm.
Our team has a demonstrated legacy of results including:
- 112% Increase in Event Reporting
- 27-Fold Increase in Event Reviews
- 74% Reduction of Serious Safety Events
- 55% DECREASE in Total Medical Liability Costs
- 42% Decrease in Claims
- 47% Decrease in lawsuits
AHRQ states that Key Learnings in the CANDOR Toolkit include process redesign guidelines to:
- Engage patients and families in disclosure communication following adverse events
- Partner with Patients and families on safety solutions
- Maintain Trust with Patients and Families after harm events
- Implement a Care for the Caregiver program for providers involved in adverse events
- Analyze an unexpected outcome to learn from it and prevent future adverse events
- Establish a resolution process for the organization
- Enhance Joy and Meaning for Care Team Members
- Provide Safer Care to Everyone