Trust as a Workflow: How Risk Technology Supports CANDOR in Healthcare 

Consider this scenario: A patient in a busy ICU receives the wrong medication dosage due to a mislabeled syringe. The error is caught, and the patient stabilizes, but the event sets off a cascade of uncertainty. Nurses hesitate to document what happened, unsure if they’ll face blame. Risk management isn’t notified until hours later. When the patient’s family expresses concern, the care team fumbles because they don’t know what they’re allowed to say or when to say it.  

This incident reflects a pattern all too familiar in healthcare: a lack of clarity, support, and trust among the care team leads to communication breakdowns. And communication breakdowns put patients and providers at risk.  

CANDOR (Communication and Optimal Resolution), a healthcare risk management and patient safety framework, was developed by the Agency for Healthcare Research and Quality (AHRQ) to help healthcare teams respond in a timely, thorough, and just way when unexpected events cause patient harm. 

With the right technology, you can embed CANDOR in of everyday workflows by supporting policies and training programs to build a culture of trust and communication.  

Trust is a Workflow: Building the Operational Layer of CANDOR 

Trust in healthcare is built moment by moment, especially in the critical hours following an adverse event. But maintaining that trust requires more than good intentions. It requires a system that guides every stakeholder, from the bedside to the boardroom, through a consistent and timely process. When CANDOR principles are embedded directly into workflows, they become actionable, repeatable, and accountable.  

Technology plays a pivotal role in enabling that consistency.  

Real-Time Event Reporting 
CANDOR starts with awareness at the point of care. When event reporting is overly complex or fragmented, it introduces delays and discourages follow-through.  

Systems that offer intuitive, role-specific interfaces make it easier for frontline staff to document events in real time, standardize the information captured, and reduce reporting fatigue. Mobile accessibility and guided forms further streamline input, helping ensure that critical details don’t fall through the cracks.  

Structured Disclosure Workflows 
Disclosure is one of the most sensitive phases of the CANDOR process. It involves legal, clinical, and emotional dimensions, and it must be handled with both care and consistency. Technology-supported workflows can automate task assignments, generate time-based alerts, and route communication protocols to the appropriate teams.  

This reduces reliance on manual tracking and ensures that patients and families receive timely, clear, and compassionate communication, regardless of where the event occurred or who is on call. 

Integrated Follow-Up and Resolution 
Disclosure is not the final step. Follow-up conversations, care plan adjustments, patient communication, and claims involvement all play a role in resolving harm. When these processes exist in isolation, they increase the risk of duplication, miscommunication, or incomplete documentation.  

Systems that integrate event reporting with downstream activities allow legal, risk, and clinical teams to collaborate more effectively, ensuring that resolution is handled with transparency and continuity. 

Audit-Ready Documentation 
CANDOR principles are not just about doing the right thing but also about proving that it was done. Comprehensive, time-stamped records of each step in the disclosure and resolution process allow organizations to demonstrate compliance with internal protocols and external standards, including guidance from the Agency of Healthcare Research and Quality (AHRQ) and the American Society of Care Risk Management (ASHRM). Audit-ready documentation also reduces administrative burden during accreditation reviews or legal proceedings, strengthening both accountability and efficiency.  

By embedding trust in workflows, organizations remove ambiguity and reduce variability — two of the most common barriers to consistent CANDOR execution.  

Making Culture Measurable: The Role of Data and Dashboards 

Yes, CANDOR is about communication, but it is also about data that comes from learning. According to the AHRQ CANDOR Toolkit, organizations must be able to track how adverse events are reported, how disclosure conversations are conducted, and how resolution efforts are completed. Without this visibility, it’s impossible to identify breakdowns, ensure consistency, and evaluate whether culture changes are taking hold.  

Integrated data systems allow organizations to track indicators such as:  

• Time from event to disclosure 

• Documentation of disclosure conversations and follow-up 

• Frequency of resolution actions across departments or facilities 

Dashboards and reports help make these indicators actionable. They enable leaders to see where workflows are succeeding, and where they’re slipping. Patterns in delay, noncompliance, or variability often point to deeper system issues: gaps in training, overburdened staff, or unclear expectations. On the other hand, strong performance signals practices worth replicating. 

AHRQ makes it clear: to learn from harm, organizations must collect and analyze data in a structured way. And for CANDOR to be more than a series of conversations, it must generate insight that leads to prevention. 

Scaling CANDOR Across an Enterprise 

Implementing CANDOR in a single department is a meaningful first step, but for organizations aiming to build a culture of trust systemwide, scale is where the real challenge begins.  

CANDOR must flex across locations, service lines, and staffing models to truly be effective. That means workflows can’t be static. Systems need to accommodate variations in governance structures and reporting hierarchies without losing consistency in how disclosure and resolution are handled.  

For example, a multi-state health system might configure slightly different reporting protocols at the local level while enforcing a shared disclosure timeline and centralized resolution oversight. Technology that supports this balance enables both autonomy and alignment. 

Scalability also depends on having a shared source of truth. When all stakeholders (from frontline nurses to legal counsel to patient relations) operate within a connected framework, the organization can ensure that cultural transformation doesn’t stop at the pilot stage. It becomes embedded in how care is delivered and how harm is addressed, everywhere.  

Operationalizing Trust, One Workflow at a Time 

CANDOR is not a one-time initiative. It’s a shift in how healthcare organizations respond to harm, build trust, and demonstrate accountability. That shift sticks when it’s supported by systems designed for transparency, follow-through, and scale. When workflows align with values, and data turns culture into something measurable, transparency stops being a talking point and it becomes the way things are done. 

With the right operational foundation, healthcare organizations can deliver consistently, confidently, and at scale.  

Discover how Origami Risk empowers your team to turn challenging conversations into consistent, transparent, and trust-building actions so you can reduce risk and improve patient safety. Learn more about our Healthcare Risk Management solutions or schedule a demo today to experience firsthand how Origami Risk can help facilitate CANDOR for your team.