Communication
Share what is known, explain the review process and maintain timely contact with patients and families.
About the care approach
Communication, apology and resolution after medical injury
The CARe approach offers a structured way to communicate promptly, review unexpected outcomes, support everyone involved and pursue a fair response based on what is learned.
CARe is an educational framework, not a substitute for case-specific medical or legal advice.
What CARe means
Three connected commitments
CARe stands for communication, apology and resolution. It is used to describe a coordinated response by care organizations and liability teams when an unexpected medical outcome may have caused harm.
Apology
Acknowledge the impact of the event and, when review identifies an error, respond with appropriate accountability.
Resolution
Explain findings, discuss corrective action and consider fair support or compensation when appropriate.
Purpose and objectives
A more constructive response to unexpected harm
The approach is intended to improve transparency while preserving each patient’s right to seek legal advice or pursue legal action. It does not predetermine whether care was appropriate or whether compensation is warranted.
- Support patients and families with clear, timely information
- Help clinicians communicate after an unexpected outcome
- Investigate events carefully and explain the findings
- Use lessons from errors and near misses to improve safety
- Consider fair resolution without requiring litigation where appropriate
How CARe works
From immediate needs to lasting improvement
The details vary by organization and case, but a responsible process generally follows four stages.
Respond
Address urgent care needs, acknowledge the concern and explain what is known at that time.
Investigate
Preserve relevant information and conduct a careful patient-safety and clinical review.
Explain
Meet with the patient or family to discuss findings, answer questions and describe next steps.
Resolve and learn
Consider appropriate support and resolution, then translate lessons into safer systems.
What to expect
Communication continues throughout the review
The first conversation should distinguish confirmed information from details that remain under review. Patients and families can be told how the event may affect ongoing care, who will provide updates and what support is available.
After an investigation, organizational representatives should explain what the review found and whether medical management contributed to the injury. When an error caused harm, the response may include an apology, corrective action and discussion of appropriate financial compensation. Patients may seek independent legal advice and can bring an attorney to meetings, especially when compensation is discussed.
If the review concludes that the care was reasonable, patients and families should still receive a thorough explanation and an opportunity to ask questions. The event can also be examined for broader safety lessons, regardless of the liability conclusion.
Important: Participation in a communication-and-resolution process does not remove a patient’s legal rights. Questions about deadlines, releases, compensation or an individual claim should be directed to a qualified attorney.
Why use this approach?
Adversarial disputes can delay answers, strain therapeutic relationships and make learning more difficult. A structured response seeks to reduce secrecy and uncertainty by separating immediate communication, independent review, accountability and safety improvement into clear responsibilities.
For patients, the goal is better access to understandable information and a timely response. For clinicians, it offers a supported route for honest communication. For organizations, it can identify system weaknesses that should be corrected before similar events occur again.
Further reading
Background documents
These archived materials provide additional context. Some documents describe earlier programs or legal conditions and should be read as historical resources rather than current legal guidance.
Detailed CARe description
A longer explanation of the model, its intended participants and the sequence of communication and review.
Model overview
An archived overview introducing communication, apology and resolution in a healthcare setting.
Historical legal context
Background material covering related models and legal developments through 2007.
Resource library
Find educational materials on implementation, patient safety, evidence and policy.
Frequently asked questions
Practical questions about CARe
Does CARe apply only when an error is proven?
No. Communication and support should begin while the facts are still being reviewed. Findings about causation, preventability and resolution come later.
Does participating affect a patient’s right to legal action?
The approach is not intended to remove legal rights. Patients should obtain independent legal advice about their circumstances, applicable deadlines and any proposed agreement.
Is compensation always offered?
No. Compensation depends on the facts, findings and applicable process. A transparent explanation and opportunity to ask questions remain important even when compensation is not offered.
Can a patient bring an attorney to a meeting?
Yes. The source model encourages patients to consider legal representation, particularly for meetings involving financial compensation.
What happens when the review finds the care was reasonable?
The organization should explain its findings, answer questions and describe any relevant learning. It may also defend the care if a legal claim is pursued.
How does the process improve patient safety?
Events and near misses can reveal communication gaps, workflow weaknesses or system hazards. Organizations can assign corrective actions and monitor whether improvements are sustained.
Where can patients and clinicians find separate guidance?
Macrm Injury provides dedicated sections for patients and providers, along with a broader resource library.
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