Early Discussion and Resolution (EDR): Frequently Asked Questions

Yes. Any party can ask to use a mediator and working with a mediator is totally optional.

Check out our mediator resource to learn more about working with a mediator, as well as browse our list of qualified people to work with.

All information in an EDR Request for Conversation is private and will only be shared with the people named in the request. The Oregon Patient Safety Commission is prevented by law from reporting the details of the request to anyone else (ORS 31.260 to 31.280)

All EDR conversations are also protected (ORS 31.260 to 31.280). All written and oral communication connected with the conversation is confidential, may not be disclosed, and is not admissible as evidence in any subsequent adjudicatory proceeding. However, if a statement is material to the case and contradicts a statement made in a subsequent adjudicatory proceeding, the court may allow it to be admitted.

Note: All expressions of regret and apology are protected under ORS 677.082.

No. The Oregon Patient Safety Commission will not be a part of the conversation. You may invite other people to join you for consultation and support.

There are no restrictions on who can attend a conversation. Patients, healthcare providers, and facility representatives can attend and may invite other people. For example:

• Patients may invite family members, friends, or others who can provide support.

• Facilities may invite providers or others with insight into the event.

• Providers may invite a trusted coworker who is able to protect the confidentiality of the discussion.

• Any party can invite an interpreter.

• The parties may mutually agree to hire a mediator. The cost of the mediator will be shared equally unless another agreement is made.

• Any party can invite an attorney or liability insurer.

The Oregon Patient Safety Commission recommends that the initial conversation takes place as soon as possible and generally within 72 hours of discovery of the adverse healthcare event, even if the investigation is not complete. You may be aware of the event immediately, or you may learn about the event when you receive a Request for Conversation. In some cases, the patient request may come long after the event. Patients may be hesitant to raise their concerns at all, may not be aware of the harm immediately, or may not be aware of EDR. Subsequent conversations can be held once more information is available.

There are no requirements for what to include in a conversation and every conversation will be different.

A conversation may include:

• An acknowledgement of the patient’s experience

• Information about what happened, why it happened, and whether it was preventable

• The possible impact of the event on the patient’s health, treatment, and follow-up care

• How additional information will be shared with the patient in the future

• An apology

• An offer of financial or non-financial restitution

• What is being done to improve care for future patients

EDR does not change federal reporting requirements to the National Practitioner Data Bank (NPDB). The NPDB Guidebook states that, “To be reported to the NPDB, a medical malpractice payment must be the result of a written complaint or a written claim demanding monetary payment for damages.”

If you have questions about NPDB reporting requirements, consult with your malpractice insurance carrier or your legal counsel. The memo signed by the Secretary of the Department of Health & Human Services on May 22, 2014 offers further clarification.