Open communication
Share what is known in understandable language, acknowledge uncertainty and provide appropriate updates as a review progresses.
About Macrm Injury
Supporting a clearer response to medical injury
Macrm Injury is an educational resource for patients, families, clinicians, care organizations and attorneys seeking to understand communication, review, support and fair resolution after unexpected harm.
A practical framework centered on openness, accountability, support and learning.
Our purpose
Turning difficult events into informed action
The work presented by Macrm Injury grew from a Massachusetts initiative to identify barriers to communication-and-resolution programs and develop a practical path for implementation. The archive describes collaboration among care organizations, insurers, professional groups and patient advocates.
Its central subject is the Communication, Apology, and Resolution approach, often shortened to CARe. This framework encourages timely recognition of medical injury, candid communication, careful review, appropriate support and a fair response based on what is learned.
- Make room for patients and families to be heard
- Support clinicians and staff through a structured process
- Review events carefully and communicate findings clearly
- Use lessons from harm to strengthen systems of care
Core principles
What the approach emphasizes
The framework is not a substitute for individualized clinical or legal advice. It is a way to organize communication and institutional response when an unexpected outcome raises concern.
Timely response
Address immediate care needs, preserve relevant information and begin communication without avoidable delay.
Accountability
Explain findings responsibly and consider apology, support and resolution when the review indicates they are appropriate.
Support for everyone
Recognize the needs of patients, families and care teams while maintaining respectful, accurate communication.
Fair resolution
Consider a proportionate response based on the facts, the impact of the event and applicable professional processes.
Continuous learning
Translate review findings into practical changes, follow-up and shared learning intended to reduce recurrence.
Our goals
Building shared understanding
Macrm Injury organizes material for people who enter the process from different perspectives but need reliable common ground.
Browse resourcesSupport implementation
Provide educational material that helps care organizations understand the stages, responsibilities and communication needs within a CARe process.
Share practical lessons
Preserve useful background documents and implementation learning so organizations can consider what may apply in their own settings.
Inform stakeholders
Explain the approach for patients, attorneys, clinical leaders, administrators and others involved in responding to medical injury.
Encourage safer systems
Connect transparent response with review, follow-up and improvements intended to reduce the chance of similar harm.
Background
How the initiative developed
The source archive documents a multi-stakeholder effort that began with research and planning in Massachusetts. Dates below describe that historical development; they do not imply that every early program remains active in the same form.
2010 — Research and roadmap
Planning work examined barriers to communication-and-resolution programs and outlined a route toward broader implementation.
2011 — Stakeholder review
The proposed roadmap was considered by participants representing several perspectives within health care and patient safety.
2012 — Public implementation phase
The roadmap became public, an alliance was formed and participating care sites began applying and refining the approach.
Ongoing — Education and learning
Archived documents continue to offer context for organizations and individuals exploring transparent communication and fair resolution.
Documents and context
Explore the original framework
These source-page links lead to background documents and related material preserved within the site.
Roadmap document
Review the planning document created to address medical liability, patient safety and barriers to communication-and-resolution implementation.
Open the full roadmapExecutive summary
Read a shorter overview of the roadmap’s principal aims and proposed implementation work.
Open the executive summaryInitiative overview
View the archived overview of the initiative and its communication, apology and resolution model.
Read the overviewLegislative background
Review archived provisions associated with the Massachusetts health care reform context described by the source material.
Open the legislative provisionsFrequently asked questions
About this resource
What does CARe mean?
CARe refers to Communication, Apology, and Resolution. It describes a structured response that can include immediate support, communication, event review, explanation, apology when appropriate, fair resolution and safety improvement.
Who is this site for?
The material is organized for patients, families, clinicians, administrators, attorneys and others seeking general information about responses to unexpected medical harm.
Does Macrm Injury investigate individual cases?
No. This is an educational website and does not conduct clinical, regulatory or legal investigations.
Does the site provide medical or legal advice?
No. The content is general information. Questions about treatment, rights, deadlines or individual circumstances should be directed to appropriately qualified professionals.
Is an apology the same as determining legal responsibility?
Not necessarily. Communication, expressions of concern and legal responsibility are distinct issues whose treatment can depend on the facts and applicable law.
Where can care organizations find practical material?
The provider and resource-library sections organize implementation guidance, background reading and documents for clinical and administrative audiences.
How can I suggest a correction or resource?
Use the contact route below to send a concise description of the correction or educational material for editorial review.
Help improve Macrm Injury
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