On-Demand Learning Lab: Communication and Resolution Programs: An Emerging Best Practice for Addressing Patient Harm-Learning Lab AUG21 On-Demand Web Access

Video Transcription

Video Summary

NACU hosted a Live Learning Lab featuring Dr. Thomas Gallagher (University of Washington) on Communication and Resolution Programs (CRPs), an emerging best practice for responding to patient harm. Gallagher argues that while harm is sometimes unavoidable, typical organizational “reflexes”—avoidance, fear, mixed messaging about apologies, and poorly integrated processes—often worsen suffering for patients, families, and clinicians, undermine trust and culture, and reduce learning. CRPs offer a comprehensive, principled, systematic approach that should be applied consistently to all harm events; they are fundamentally quality-and-safety programs, not claims-reduction tactics.<br /><br />Gallagher outlines core CRP elements: early incident reporting; ongoing transparent communication with patients/families; timely, systems-oriented event analysis and improvement; care-for-the-caregiver (peer support); patient/family engagement throughout; and, for a subset of cases involving error or system failure, proactive financial and non-financial resolution. He emphasizes timeliness (e.g., initial investigative steps within ~72 hours and completion within 30–45 business days) and the need to train clinicians for harm conversations, as patients often rate these discussions far worse than physicians do. Key communication guidance includes acknowledging what happened, sharing known facts without speculation, expressing empathy and regret, setting expectations for next steps, and avoiding early fault-admitting statements or promises about compensation.<br /><br />Implementation requires C-suite/board commitment, readiness and gap assessments, workflow integration (including software), and robust metrics tracking environment, process steps, high-severity events, and outcomes. Gallagher also introduced the PACT 18‑month collaborative to support CRP adoption. Q&A addressed peer support confidentiality, leadership buy-in, moving away from “second victim” terminology, and debriefing approaches.

Keywords

Communication and Resolution Programs (CRPs)

patient harm response

transparent disclosure communication

apology and empathy in healthcare

systems-oriented event analysis

care-for-the-caregiver peer support

patient and family engagement

proactive financial resolution

quality and safety improvement

leadership commitment and metrics tracking