Early Discussion and Resolution Marks Two Years of Open Conversation
On October 31, the Oregon Patient Safety Commission (OPSC) released the second annual report on the Early Discussion and Resolution (EDR) program—Early Discussion and Resolution Annual Report: July 2014-June 2016. Created by the Oregon Legislature in 2013, EDR has offered patients and healthcare providers a constructive way forward when things go wrong during healthcare. This report provides an overview of EDR activity in the first two years, offers lessons learned during implementation, and gives recommendations for improvement. The report also summarizes OPSC’s ongoing work to ensure EDR’s success in supporting the Oregon healthcare community and the population it serves.
In the first two years, 67 Requests for Conversation were filed with OPSC. Year two saw a 31% increase in requests over year one (and year three is on track to sustain that healthy rate of increase). Patients made more than 85% of requests. Although fewer than half of all requests for a formal EDR conversation were accepted, about three-quarters of them resulted in a conversation of some kind. Undoubtedly, the availability of the EDR request process increased communication between patients and providers following an adverse event, even when facilities chose to use their own process to have the conversations.
OPSC is committed to sharing what we have learned. In the last year of EDR implementation, we have observed the following:
Organizations that promptly communicate with patients and families following adverse events may more easily reach resolution
An organizational culture of safety enables implementation of communication and resolution processes
Coordination between multiple stakeholders adds complexity
EDR creates opportunities for conversation between patients and their healthcare providers even when the formal EDR process is not used
Patients may need assistance to advocate for themselves effectively during EDR conversations
The Lessons Learned section of the report discusses these findings, as well as recommendations for improvement. OPSC will be highlighting some of these recommendations in future EDR Insiders—a recurring article in our monthly newsletter. We want to hear from you! Look over our recommendations, and let us know if you think we are on the right track.
The report also describes the work OPSC is doing through the Oregon Collaborative on Communication and Resolution Programs (OCCRP) to accelerate long-term culture change among Oregon’s healthcare professionals. With EDR and the OCCRP, Oregon has become an important participant in the larger national conversation about how to improve patient safety by promoting transparency and accountability. We’re proud of that, but what really excites us is all we are learning about how to better support you and the entire healthcare community in communicating openly with patients and families after an adverse event.