How Hospital Leaders are Decreasing their Healthcare Professionals’ Burnout through the CANDOR Program

Abstract

The Communication and Optimal Resolution (CANDOR) program, a patient safety and medicolegal program, has been implemented or in the process of being implemented in over 800 US hospitals. The program was designed to help patients suffering from unexpected adverse outcomes and the healthcare professionals who take care of the patients. The CANDOR program’s basic premise emphasizes honesty in medical error situations. It mainly aims to help patients experiencing unexpected adverse outcomes, prevent the recurrence of medical errors, and help healthcare professionals cope with the aftermath of their patient suffering an adverse outcome. Studies have evidenced that, compared to the common US practice “Deny, Delay, and Defend,” using CANDOR not only benefits current and future patients but also improves the well-being of healthcare professionals. CANDOR can be considered a form of “Just Culture,” which has been implemented within industrial, aviation, and healthcare settings and provides several beneficial effects. Each sector has modified “Just Culture” to their context. This paper therefore aimed to describe CANDOR and summarizes studies that have investigated the benefits and costs of its hospital implementation in comparison to the practice of “Deny, Delay, and Defend.” This paper describes how CANDOR teams, which include physicians, attorneys, patient advocates, and health policy leaders, successfully persuaded hospitals to change their cultures from cultures of opaqueness regarding medical errors and their consequences to cultures embracing transparency.