Successful System Implementation of a Communication and Resolution Program

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Stephen Pearlman, MD, MSHQS Michele Campbell, RN, MS Peter Lodato, MPH


Communication and Resolution Programs (CRP) are becoming more commonplace in the United States. ChristianaCare adopted this approach after participating in a demonstration project through the US Agency for Healthcare Research and Quality in 2014-5. This paper documents our successful implementation of our CRP and the first five years of our results. Our organization saw increased reporting of medical events, improved patient safety, mitigation of medico-legal risks and improved patient and caregiver experience. The path to implementation is challenging and represents a major shift in how organizations deal with unexpected medical outcomes. The process is complex involving individuals from patient relations, risk management and patient safety. But the benefits are satisfying. Keys to success include strong leadership support and engagement of a multidisciplinary team.

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PEARLMAN, Stephen; CAMPBELL, Michele; LODATO, Peter. Successful System Implementation of a Communication and Resolution Program. Medical Research Archives, [S.l.], v. 9, n. 10, oct. 2021. ISSN 2375-1924. Available at: <>. Date accessed: 29 nov. 2022. doi:
Research Articles


1. Kraman S, Hamm G. Risk Management: Extreme honesty may be the best policy. Ann Intern Med. 1999; 131(12):963-967.
2. Boothman RC, Imhoff SJ, Campbell DA. Nurturing a culture of safety and achieving lower malpractice risk through disclosure: lessons learned and future directions. Front Health Serv Manage. 2012;28(3):13-28.
3. Kachalia A, Kaufman SR, Boothman R, Anderson S, Welch K, Saint S, Rogers MAM. Liability claims and costs before and after implementation of a medical error disclosure program. Ann Intern Med. 2010; 153(4):213-221.
4. Mello MM, Kachalia A, Roche S, Van Neil, Buchsbaum L, Dodson S, Folcarelli P, Benjamin, EM, Sands, KE. Outcomes in two massachusetts hospital systems give reason for optimism about communication-and-resolution programs. Health Aff. 2017; 36(10):1795-1803.
5. Lambert BL, Centomani NM, Smith KM, Helmchen, Bhaumik DK, Jalundhwala YJ, McDonald TB. The “seven pillars” response to patient safety incidents: effects on medical liability processes and outcomes. Health Serv Res. 2016; 51(6): 2491- 2515.
6. Colorado Candor Act Resources. 2021 [cited 8/17/2021]. Available from
7. BETA HEART. 2021. [cited 8/17/2021]. Available from
8. Clinton HR, Obama B. Making patient safety the centerpiece of medical liability reform. N Engl J Med. 2006; 354(21):2205-2208.
9. Wojcieszak D, Banja J, Houk C. The sorry works! coalition: making the case for full disclosure. Jt Comm Qual Pt Saf. 2006; 32(6):344-350.
10. Gallagher TH, Boothman RC, Schweitzer L, Benjamin EM. Making communication and resolution programmes mission critical in healthcare organisations. BMJ Qual Saf. May 2020; 0:1-4.
11. McDonald TB, Van Neil M, Gocke H et al. Implementing communication and resolution programs: lessons learned from the first 200 hospitals. J Patient Saf Risk Manag. 2018; 23(2):73-8.
12. Plews-Ogan M, May N, Owens J et al. Wisdom in medicine:what helps physicians after a medical error? Acad Med. 2016; 91(2):233-241.
13. Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med. 2007; 356(26):2713-2719.
14. Bell SK, Smulowitz PB, Woodward AC, Mello MM, Duva AM, Boothman RC, Sands K. Disclosure, apology, and offer programs: stakeholders’ views of barriers to and strategies for broad implementation. The Milbank Quarterly. 2012; 90(4):682-705.
15. Murtagh L, Gallagher TH, Andrew P, Mello MM. Disclosure-And-Resolution programs that include generous compensation offers may prompt a complex patient response. Health Aff. 2012; 31(12):2681-2689.
16. Communication and Optimal Resolution (CANDOR) Toolkit. 2021. [cited 8/17/2021]. Available from
17. Mello MM, Roche S, Greenberg Y, et al. Ensuring successful implementation of communication and resolution programmes. BMJ Qual Saf January 2020. 29:895-204.
18. LeCraw FR, Montanera D, Jackson JP, et al. Changes in liability claims, costs, and resolution times following the introduction of a communication and resolution program in Tennessee. J Patient Saf Risk Manag. 2018;23(1):13-18.
19. Gallagher TH, Waterman AD, Ebers AG et al. Patients’ and physician’s attitudes regarding the disclosure of medical errors. JAMA 2003; 289(8): 1001-1007.