Adverse Event: An adverse event is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment.

Communication Resolution Program: CRPs are an approach to handling adverse events that require health care organizations to provide open and transparent communication while prioritizing the needs of patients, families and providers and ultimately improving patient safety within the organization.

CRP Certification and Review Panel: CRP Certification allows healthcare providers and organizations that have used the CRP approach to have a neutral group of patient advocates and patient safety experts (CRP Review Panel) review the response to a particular case and determine whether the patient’s needs have been met, that any individual or system-level inadequacies have been addressed, and learning has occurred. CRP Certification does not alter current requirements for mandatory reporting of certain events to MQAC and other regulatory commissions. Applicants are responsible for submitting all applicable information to MQAC or other agencies in addition to their CRP Certification application. Applications for CRP Certification, and information contained therein, will not be forwarded to MQAC by the CRP Certification program. 

CRP Validation: CRP Validation allows healthcare providers and organizations that are using a CRP approach in response to an adverse event receive real-time feedback from the CRP Review Panel. This opportunity for real-time feedback gives organizations the chance to have additional, expert eyes on the event and to ensure that their actions are on track to be CRP Certified. Due to this process happening in real-time, if challenges arise during the organization’s CRP response, the organization can receive support troubleshooting those challenges with the CRP Review Panel. Organizations can submit applications for CRP Validation at any point during the CRP response.

Statement of Understanding (SOU): One of the main participation benefits to providers who submit an event for CRP Certification, is the streamlining of event reporting, alleviating them from a potentially complicated event review by the Medical Quality Assurance Commission (MQAC). The MQAC has been a crucial partner in launching CRP Event Certification, and holds a “Statement of Understanding” with the Foundation for Healthcare Quality detailing the oversight of each agency in adverse events where a CRP was employed. MQAC retains its authority of disciplinary oversight in their reviewing of adverse events. However, the SOU asserts MQAC’s acknowledgment of the CRP Certification activity as a valid process committed by well vetted experts, and therefore MQAC agrees to look favorably on a certified event in terms of pursuing any additional disciplinary action against involved providers.

“CRP essentials”: While communication resolution programs might vary from institution to institution, CRPs are most successful when quality and safety are prioritized within an organization, and leadership and staff work to align internal processes and incentives with those priorities.  Healthcare organizations, liability insurers, and clinicians consistently follow these practices when they use a CRP successfully to respond when patients are harmed in the course of their medical care. The essential CRP practices are:

1. Immediately report adverse events to the healthcare institution (within 30 minutes of the event’s discovery).
2. Communicate with patients about what happened, whether it was preventable, why it happened, and how recurrences will be prevented.
3. Analyze adverse events using human factors principles and develop action plans to prevent recurrences.
4. Support the emotional needs of the patient, family and care team.
5. Proactively and promptly offer financial and non-financial resolution to patients and families when care is unreasonable.
6. Educate patients and families about their right to seek legal representation at any time.
7. Work collaboratively with involved healthcare organizations and professional liability insurers to resolve adverse events.
8. Assess the effectiveness of the CRP using tested and accepted measures.

Regulatory body: Health care regulations and standards are necessary to ensure compliance and to provide safe health care to every individual who accesses the system.  Health care regulatory agencies in turn monitor practitioners and facilities, provide information about industry changes, promote safety and ensure legal compliance and quality services. Federal, state and local regulatory agencies often establish rules and regulations for the health care industry, and their oversight is mandatory. Some other agencies, such as those for accreditation, require voluntary participation but are still important because they provide rankings or certification of quality and serve as additional oversight, ensuring that health care organizations promote and provide quality care.

CQIP and Confidential Work Product : Coordinated quality improvement programs (CQIP) is a designation of work confidentiality provided by the Washington State Department of Health to organizations or activities dedicated to quality improvement in healthcare. CQIP plans approved by the department are provided discovery limitations under RCW 43.70.510 (3) and (4). Information and documents specifically created for, collected, and maintained by an approved quality improvement committee are referred to as work product, and are also exempt from disclosure under RCW 42.56.360 (1) (c). Communication Resolution Program and CRP Event Review activities, documents, and work product are all designated CQIP confidentiality protections under Washington State Law. 

Licensee: In the context of Communication Resolution Programs and CRP Event Certification, this term refers to the licensed care provider who was involved in the adverse event under review. 

Foundation for Health Care Quality: The Foundation for Health Care Quality is a nonprofit organization dedicated to providing a trusted, independent, third party resource to all participants in the health care community – including patients, providers, payers, employers, government agencies, and public health professionals. The Foundation houses all Communication Resolution Program and CRP Event Certification activities through its patient safety branch, The Washington Patient Safety Coalition.