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CANDOR Promotes Safety Reporting, Employee Support at Christiana Care Health System

Rationale / Objectives

Christiana Care Health System, a Delaware teaching health system with hospitals in Newark and Wilmington, has seen an increase patient safety since introducing the Communication and Optimal Resolution (CANDOR) toolkit in 2014 following a two-year concept testing project with the Agency for Healthcare Research & Quality (AHRQ). 

Project/Program Description & Major Achievements

Since implementing the toolkit, Christiana Care Health System has reported a 23 percent increase in patient safety events. The increase in patient safety reporting includes some "near misses." Christiana Care commonly refers to these as "good catches" because staff are encouraged to report and correct unsafe conditions before they contribute to patient harm. The CANDOR process has also helped health system leaders improve interaction with patients and families when there is an unexpected outcome from care.

Lessons Learned

Staff are encouraged to report and correct unsafe conditions before they contribute to patient harm.

People / Organizations Involved

Further Description

Christiana Care was one of three health systems in the Nation to participate in an AHRQ-funded, 2-year demonstration project that tested the effectiveness of the CANDOR process. As part of implementing the CANDOR process, Christiana Care established a "Care for the Caregiver" program, a peer support system in which health care team members know they will be supported and treated in a just and fair manner and can quickly return to practice.

Major Achievements

The CANDOR process has also helped health system leaders improve interaction with patients and families when there is an unexpected outcome from care. According to studies, this happens to about 1 in 10 patients nationally, despite the best efforts of doctors, nurses, and other health care professionals. The CANDOR toolkit gives hospitals the tools they need to engage in candid, empathetic communication with patients and families to achieve a timely resolution of the situation, without the need for litigation.