How Early Intervention After Harm Events Helps Everyone Heal Sooner

The following week, the mother brought the young girl to the emergency department (ED) of a local hospital. The ED clinician performed an examination of her abdomen and ordered a viral test. After the test results returned as negative, the ED clinician prescribed amoxicillin.

Several days later, the mother took her daughter to a different ED. After an abdominal exam, the ED clinician ordered imaging which revealed a mass on her right kidney. The ED clinician then transferred her to a tertiary hospital where a surgical team removed both the kidney and the cancerous tumor. The young girl made a full recovery.

The first step to healing: Reporting

The young girl’s family expressed their distress about the delay in diagnosis to the clinic and the first ED. After reporting the delay to Constellation, our early intervention team stepped in to assess the situation.

A key element toward resolution after a harm event is the expert case review, a service available to Constellation’s policyholders as part of our early intervention program, HEAL. By accessing Constellation’s network of experts in each medical specialty, our team was able to quickly and accurately assess the care that was provided. Through this review, we learned that there were issues with the care provided by both the clinic provider and the first ED, which allowed us to efficiently move the process forward.

While expert reviews were pending, our early intervention consultants were in close communication with both the patient’s family and the impacted care teams. Our teams have deep risk and clinical expertise that allow us to offer guidance on communication, compensation and other resolution approaches. Our team shared the results of the expert reviews with the care team and worked together to determine the appropriate next steps.

Closing the loop: Listening

Of all the activities our teams undertake, the most important one is often the simplest: listening. After expert reviews of this case were complete, Constellation’s consultant then met with the patient’s family. They had an in-depth discussion about the family’s concerns and their frustrations around the delay in diagnosis of the kidney tumor.

The family desired to be heard and to know the clinicians and care teams were taking steps to reduce the chance of a similar delay happening to other patients.

The clinicians and care teams were in alignment with this goal, using the medical expert reviews to improve care. By improving care processes, the teams were able to address the family’s needs—and simultaneously improve care.

Working together

We understand the stress a delay in diagnosis can cause. There are many ripple effects for all involved. In this case, Constellation’s team was able to collaborate and deescalate the situation so that all involved were able to heal and move on in a matter of weeks.

Early intervention facilitates resolution and minimizes additional harm for everyone involved. By collaborating early, clinicians, care teams and health care organizations can benefit from our expert case reviews, communication assistance, clinician peer support and the expertise of our risk consultants.

At Constellation, we believe that what’s good for care teams is good for business. Supporting clinicians—and their patients and senior living residents—through early intervention of harm events is just one of the many ways that we deliver on our purpose.

Learn more about Constellation at ConstellationMutual.com.

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