Target Audience

Physicians, Patient safety leads, risk management leads, claims staff, legal counsel, clinical leads.

Series OVERVIEW

The intent of the summer Candor training series is to familiarize network hospitals with the early disclosure process, Communication and Optimal Resolution (Candor). Candor is a powerful tool that works to maintain relationships with patients and families after an adverse event through immediate and frequent communication. It provides care for the caregiver and creates a culture of learning and process improvement throughout the facility.

Through this training series Iowa Healthcare Collaborative, Iowa Medical Society, Iowa Hospital Association and MedStar Institute for Quality and Safety will guide hospitals through the various elements of the Candor process and provide the tools needed for effective implementation at their facility.

Workshop Description

During this interactive and experiential workshop attendees will use de-identified cases of medical harm to work through the processes of using the results of event investigation to determine whether care was appropriate in a way that is consistent with the principled, comprehensive and systematic approach to patient harm. In addition, cases of inappropriate care will be taken through the Iowa Candor statutory methodology with full application of the processes. Financial and non-financial options for resolution will be described and applied with the use of enactments involving trained actors.

Learning Objectives

• Describe the approach to determining appropriateness of care following patient harm events.
• Outline the Iowa Candor legislation and how it is used during the process of resolving patient harm events.
• Use empathic communication skills during financial resolution conversations.

Agenda

PROGRAM NOTES

Dress for the conference is business casual. Layered clothing is recommended for your comfort.

HANDOUT INFORMATION

These are paperless workshops. You will be notified via email when the handouts are available online, with a direct link to access the files. Paper copies of handouts will not be available onsite at the conference.

Resources

• AHRQ Building the Business Case for Candor Worksheet 
• AHRQ Gap Analysis Process 
• AHRQ Candor Event Checklist
• AHRQ System-Focused Event Investigation and Analysis Guide
• AHRQ Communication Assessment Guide
• AHRQ Disclosure Checklist
• AHRQ Care for the Caregiver Implementation Guide

Speakers

Jack Gentry graduated from Loyola University with bachelor’s degrees in political science and American history. He spent 37 years as a Baltimore City police officer, he was also a member of the SWAT team and a hostage negotiator. While looking forward to an active retirement he was seriously injured as a result of a medical error during an elective surgery to repair two bulging discs in his neck and is paralyzed from the neck down. His story exemplifies how a determined patient working together with a dedicated physician and a health system that live their values of caring and transparency can move forward and make the best of a tragic, life-altering situation. The hospital involved immediately disclosed what had occurred during surgery and then stayed in communication with Gentry and his family to ensure their needs were being met during months of rehabilitation and adjustment to the new realities of their life. Gentry and his wife, Teresa, have become vocal advocates for MedStar’s approach and the larger movement across the country in the way healthcare providers respond to unintended medical harm.

Teresa Gentry received a bachelor’s degree in nursing from the University of Delaware. She has worked in healthcare systems and schools in the Baltimore region. She began her nursing career at Johns Hopkins Hospital, caring for general surgery, cardiac, orthopedic and neurosurgery patients. She was also the coordinator and instructor in their Nurse Internship Program. Later she worked in staff development, utilization review and quality assurance at other Maryland hospitals. In 2015, after spending 16 years as a school nurse at Calvert Hall High School, she retired to be more available to care for her husband. She has joined him as a patient safety advocate with an interest in full disclosure and apology when medical harm occurs.

Jennifer Gonsalves is a claims manager in the corporate risk management department of MedStar Health, managing professional and general liability claims across the system. She obtained a bachelor’s degree in psychology from Hollins University and a bachelor’s degree in nursing from the University of Maryland. She worked as a registered nurse in the Arlington Hospital Emergency Department until 2000. While working as a nurse Gonsalves earned her Juris Doctor degree from the University of Baltimore. Before joining MedStar Health’s corporate risk management team as a claims manager in September 2014, Gonsalves worked as a clinical risk manager at the MedStar Washington Hospital Center and as a director of risk management at MedStar Georgetown University Hospital.

Michael McCoy, MD, is a board-certified obstetrics and gynecology physician from West Burlington who serves as CMO at Great River Health System. In 2013, he chaired the Iowa Medical Society Task Force that first identified the early disclosure concept. He has fought tirelessly ever since to help educate his peers around the state to change the culture in Iowa from deny and defend to a more patient-focused approach of disclosure and continued engagement following an unanticipated outcome. Great River Health System has been leading Iowa’s first Candor pilot site. Dr. McCoy and his facility has seen several instances of unanticipated patient outcomes resolved in a manner that satisfied their facility, providers, as well as the patient, without the need for legal action.

Timothy McDonald, MD, JD, is president for the Center for Open and Honest Communication at the MedStar Institute for Quality and Safety and a professor of law at Loyola University – Chicago. Dr. McDonald is a physician-attorney whose research has focused on the principled approach to patient harm with an emphasis on reporting of patient safety events, the use of simulation and human-factors analysis and providing open and honest communication following harm events. His federally funded research has focused on these domains and their impact on improving the quality of care while mitigating medical liability and other legal-related issues.

Kate Strickler, JD, graduated from Drake University in 2010. She has been working for the Iowa Medical Society since 2014, first as a staff attorney and now as general counsel. She advises lobbyists on the impact proposed legislation will have on physicians, evaluates compliance with state and federal regulations and is working to implement medical early disclosure program across the state of Iowa. In addition to her work as general counsel, she has a private practice in Chicago, Illinois.

Disclosures

Relevant to the content of this educational activity, the following individuals have no conflict of interests with commercial interest companies to disclose.

• Jennifer Brockman, Planning Committee Member
• Kate Carpenter, Planning Committee Member
• Jack Gentry, Speaker
• Teresa Gentry, Speaker
• Jennifer Gonsalves, Speaker
• Martin Hatlie, Planning Committee Member
• Michael McCoy, MD, Speaker
• Timothy McDonald, MD, JD, Speaker
• Kate Strickler, JD, Speaker
• Dennis Tibben, Planning Committee Member