OPSC Patient Safety Minute | Measuring Your Harm Response Process: A Resource to Help
Building measurement into your harm response process
While there’s no current, standard set of measures to understand the effectiveness of a harm response process, we now have a resoruce to help. A recent article from the Collaborative for Accountability and Improvement (CAI) outlines numerous aspects of Communication and Resolution Programs (CRPs) that could be measured (Table 1).
Regardless of where you are in your harm response process journey, this set of potential measures can help: If you’re developing your process, use this resource to help build measurement into that process. If you’re in the middle of implementing your process, this resource can help strengthen and validate your harm response measurement.
Table 1: Aspects, dimensions, and examples of CRP measurement
| Aspects | Example Dimensions | Example Measures |
|---|---|---|
| Harm events | Volume/severity | # & severity of harm events, # to which the CRP is applied (aka "CRP events") |
| N.A. | Provenance | How CRP events came to the organization's attention |
| N.A. | Type | Categories of events (e.g., diagnostic delays, medication errors, etc.) |
| N.A. | Locations/services | Places where harm events happened, the involved services |
| N.A. | Equity | Stratifying event-related measures by race, ethnicity, language, etc. |
| Communication with patients/families | Process-adherence | % patients/families getting initial communication, post-event review communication, and insurer referral when serious harm was preventable |
| N.A. | Timeliness | Time between event reports and initial communications with patients/families; time between completing event reviews and communicating the findings |
| N.A. | Effectiveness & Pt/Fam centeredness | Outcome measures: Pt/fam assessments of respect, transparency, honesty, compassion, opportunities to ask questions, etc. |
| N.A. | Equity | Stratifying communication-related measures by race, ethnicity, language, etc. |
| Support of patients/families | Timeliness | Time between event report, assessments of support needs, offers of support |
| N.A. | Types & Magnitude | Nature & scope of support offered to pt/fam (e.g., counseling, logistics, etc.,% with legal representation or other 3rd party support |
| N.A. | Effectiveness | Outcome measures: Pt/fam assessments of how well their support needs were met |
| N.A. | Equity | Stratifying support-related measures by race, ethnicity, language, etc. |
| Support of clinicians | Timeliness | Time between event report, assessments of support needs & offers of support |
| N.A. | Types & magnitude | Nature & scope of support offered to clinicians (eg, counseling, etc.) |
| N.A. | Effectiveness | Outcome measures: Clinicians' assessments of how well their support needs were met |
| Event review | Pt/fam engagement | % of CRP events that included the pt/fam narrative |
| N.A. | Timeliness | Time between event report and completion of event review |
| N.A. | Contributing factors | Aggregated learnings about the causes of events |
| N.A. | Dissemination | % of findings shared with clinicians and beyond (eg., via a PSO) |
| N.A. | Outcomes | % CRP events deemed preventable, non-preventable |
| Patient safety improvements | Timeliness | Time between event report & complete implementation of corrective actions |
| N.A. | Effectiveness | Outcome measures: Corrective action strength, unmitigated contributing factors, # of events |
| CRP outcomes | Types | % only involving communication (no litigation or compensation), % involving litigation, % involving a proactive offer of compensation, etc. |
| N.A. | Timeliness | Time between event report & completion of CRP process |
| N.A. | Malpractice experience | # of claims/suits, legal costs, indemnity payments (incl. proportion going to pt/fam who experienced preventable harm), # of NPDB reports |
| N.A. | Effectiveness | Outcome measures: Pt/fam & clinician assessments of the process, degree to which it met their needs, non-physical outcomes (emotional, psychological, financial, and socio-behavioral including trust, healthcare engagement, employment, etc.) |
| N.A. | Opportunities for improvement | Qualitative information from pt/fam and clinicians |
| N.A. | Equity | Stratifying outcomes by race, ethnicity, language, etc. |
| N.A. | Team & workload | CRP team roles, credentials, FTE, events per FTE, etc. |
| CRP resourcing | Costs | CRP team FTE, training, supporting systems (e.g., vended software), waived bills, pt/fam & clinician support expenditures, external reviews, legal representation, indemnity payments, etc. |
Resources
Sokol-Hessner L, Adams J, Hemmelgarn C, et al. Measuring how healthcare organizations respond after patients experience harm: perspectives and next steps. Front Health Serv. 2025;4:1488944. doi:10.3389/frhs.2024.1488944
Collaborative for Accountability and Improvement (CAI): CAI is dedicated to accelerating the spread of effective CRPs to healthcare organizations everywhere. Find additional resources on responding to harm events, supporting patients and families, and supporting involved healthcare professionals.
Joining the PACT Collaborative can provide additional support for measuring your harm response process.
