����APP

CommonSpirit Health, one of the Nation's largest health systems, serving 21 States, is expanding its use of AHRQ's Communication and Optimal Resolution (CANDOR) toolkit across its entire network of 140 hospitals and 1,000 ambulatory care centers. CommonSpirit Health was created in early 2019 by Catholic Health Initiatives and Dignity Health.

The health system hopes to build on its initial success implementing CANDOR training at 35 of its affiliated hospitals. The CANDOR toolkit helps hospitals, health system leaders, and clinicians communicate accurately and openly with patients and their families when something goes wrong with their care.

CommonSpirit Health clinicians have communicated promptly and candidly with patients about an adverse event or potential adverse event, and officials estimate 85 patients were spared the additional harm of not knowing what happened or why.

“CANDOR touches at the heart of what we do in healthcare,” said Barbara Pelletreau, R.N., M.P.H., CommonSpirit Health’s senior vice president of patient safety. “It’s all about how to communicate an adverse event or a potential adverse event promptly and candidly, because we believe that’s the right thing to do.”

Traditionally, hospitals and healthcare providers are not fully forthcoming with patients and families when harm occurs, and rarely so before an investigation or litigation concludes. The CANDOR process turns traditional thinking on its head, providing methods and tools for clinicians and others to respond immediately to harm while promoting candid, empathetic communication and timely resolutions for patients and caregivers.

"Our goal is to notify the patient and family within 60 minutes of an event," Pelletreau explained. “We want the patient to receive the available information as we receive it, and to let them know what we’re doing to help and what we’re doing to address the issue, so that the message is timely.”

CommonSpirit Health employees have also responded positively to CANDOR training. When an unexpected event occurs, those situations are tracked by a core management team consisting of the hospital’s chief nursing officer, quality improvement director, patient safety officer, and chief medical officer. “The CANDOR training has been highly beneficial in creating effective teams that all work together with the patient’s best interests in mind,” Pelletreau said.

The health system has found that, not only does CANDOR help patients and families, it also saves money by reducing litigation. However, “We’re never looking at events or other hard data to substantiate our position. The major point is not about lowering costs with claims, but to resolve unexpected issues so that patients can emotionally and physically heal from an adverse experience,” Pelletreau noted.

In regularly scheduled “Patient Safety Roundtables,” CommonSpirit Health clinical leaders review adverse event situations and discuss how CANDOR was helpful in each case or where the process could have been improved. They have found that CANDOR principles facilitate quicker resolutions that benefit patients and clinicians while having the unintended consequence of avoiding unnecessary expense.

“CANDOR is absolutely the right approach for all involved in an adverse event,” Pelletreau said.