Challenges of Implementing a Communication-and-Resolution Program Where Multiple Organizations Must Cooperate.

Area of Science:

• Healthcare management
• Patient safety
• Interorganizational collaboration

Background:

• Communication-and-resolution programs (CRPs) aim to improve incident resolution between healthcare facilities and clinicians.
• Implementing collaborative CRPs involving external liability insurers presents unique challenges.

Purpose of the Study:

• To implement and evaluate a collaborative communication-and-resolution program (CRP) involving healthcare facilities and their liability insurers.
• To identify barriers and facilitators to successful CRP implementation in a multi-organizational setting.

Main Methods:

• A qualitative study was conducted across six hospitals and clinics collaborating with a liability insurer over 20 months.
• Data were collected through interviews, case information, and meeting notes, then triangulated for analysis.

Main Results:

• While some cases were resolved and relationships improved, full implementation of a collaborative CRP was unsuccessful.
• Key barriers included insurer distance, lack of active leadership support, inter-organizational coordination difficulties, workload, physician nonparticipation, and existing distrust.

Conclusions:

• Collaborative CRPs involving multiple organizations are challenging to operate.
• Success factors include pre-existing trust, active leadership, physician engagement, efficient information transfer, and clear joint protocols for investigations and resolutions.