Healthcare News & Insights

Treat errors with CANDOR: Approach helps hospitals, patients

Even as hospitals work to keep preventable harm from impacting patients’ recovery, errors still occasionally happen. Some are severe enough to drastically change a patient’s quality of life. In these situations, hospitals that want to avoid a lengthy, expensive legal battle should remember the power of two words: “I’m sorry.” 

Gradually, facilities are shifting from a culture of silence surrounding medical errors to one focused on transparency and empathy, as written in an article from Kaiser Health News. More hospitals have abandoned the “deny and defend” model, where patients are told nothing about any errors that may impact their health.

One approach that’s gaining popularity is being promoted by the Agency for Healthcare Research and Quality. Dubbed Communication and Optimal Resolution, or CANDOR, it’s based on a program first used at the University of Michigan and tested at several other hospitals.

When errors occur at a hospital with a CANDOR program, patients receive a prompt apology and are compensated for their injuries. Facilities also conduct a transparent investigation of the error and make patients aware of the findings.

At hospitals that don’t use this approach, patients aren’t even made aware that an error was made during their treatment. And out of those who find out, only a small percentage of patients pursue litigation, due to its high costs, the caps on financial awards and the time involved (as these cases can take years to resolve).

Despite the barriers that exist for patients to sue healthcare providers, many fear that immediately acknowledging liability for a mistake opens hospitals to more lawsuits. However, that hasn’t happened for the facilities that have implemented a CANDOR program. In fact, the University of Michigan cut the number of lawsuits it dealt with in half during the program’s first year. It also saved $2 million in legal costs.

Getting started

Transparency is the key to implementing a CANDOR approach. Facilities must have a culture where errors can be freely disclosed and discussed. Patient safety experts often collaborate closely with professionals who handle malpractice claims so they can figure out how to keep big mistakes from happening again.

At the University of Michigan, clinical staff were encouraged to report any errors and bad outcomes they noticed with patient care. Error reports climbed drastically in the first year, from 2,400 to over 34,000. Each mistake was used as an opportunity to learn so it wouldn’t happen again, and this strategy improved patient safety.

Openly discussing and apologizing for medical errors and adverse events is the way to go in a time where facilities are being called upon to improve their quality of care, while making patients more involved in the process. Whether it’s done by implementing a CANDOR program, or through other means, hospitals need to adopt similar protocols for these situations.

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