Barriers to and Facilitators of Applying Communication and Resolution Programs in Health Care

Abstract: This thesis investigated why U.S. hospitals that had committed to implementing communication and resolution programs (CRPs) did not consistently apply their programs when patient harm events occurred. Several themes emerged from interviews with nine risk management, patient safety, and patient experience professionals: the importance of informal social networks; workload and competing priorities among key individuals; the complexity of interactions between hospital representatives and patients or families who had experienced medical harm; challenges in determining (or negotiating) which events warrant application of the CRP; and working to overcome active and passive resistance to the process. Study findings illuminate the complexity of hospitals’ responses to medical harm and suggest an agenda for further research.