In an attempt to prevent tens of thousands of patient deaths each year, and the pain and suffering of countless others, a federal agency has urged hospitals to publicly admit and investigate medical errors. In addition, the Agency for Healthcare Research and Quality (AHRQ) has introduced a new suggested protocol for hospitals to follow that emphasizes closer scrutiny of what led to a mistake, and provides better support to affected patients and their families.
Traditionally, most hospitals attempt to deal with medical errors in secret, holding back information. Rarely do they admit wrongdoing voluntarily. Investigations are kept private, the results protected by attorney-client privilege. Patients and their families remain largely in the dark – which only compounds the trauma inflicted on them by the original mistake.
The AHRQ process aims to turn this practice on its head – making transparency and openness the focus of a hospital’s response. Named Communication and Optimal Resolution (Candor), the protocol represents a turning point in how hospitals deal with medical errors, and their interactions with patients and loved ones.
For one thing, Candor mandates that trained staff notify patients and their families within one hour of an error being discovered. From the very start, there is no withholding of information – and contact is maintained from that point onwards, throughout the investigation. Billing is suspended, so injured patients – or their survivors — do not have to cope with paying for care that caused them harm.
Candor directs hospitals to finish an investigation within two months and provide the full findings to patients. A focus is placed on how the error can be prevented in the future. Perhaps the most revolutionary aspect of Candor is that it directs hospitals to offer financial compensation to patients and their families if an investigation finds evidence of malpractice. This also does not preclude patients from pursuing medical malpractice claims if they do not feel what is offered by the hospital is sufficient.
Candor has already been piloted in 14 hospitals in three health systems, including the University of Michigan. It represents a significant advance in how hospitals respond to medical errors that lead to harm or death. What remains to be seen is whether it will spread nationally – something that can only benefit the safety of this country’s patients.