CRICO’s clinical coding taxonomy is the foundation for our exceptional patient safety initiatives. The data derived from our coding of medical malpractice claims and suits are essential in developing focused interventions. Making connections within our data and drilling down the many pieces at play in the care continuum offer significant opportunities to design targeted risk mitigation efforts where it matters most.

Much like the game of Clue, we created new coding elements for Linking and Weighting data to help us to understand the who, the what, and the why. These new analysis tools provide an essential piece in understanding the true drivers of risk. There are many approaches to analyzing this data, and each one offers a different opportunity for insight.


Using the Linking and Weighting coding elements, we have been able to identify the unfolding cases related to the COVID-19 environment. Understanding this developing landscape gives us a valuable look into the vulnerabilities within the health care system and the policy changes needed to address them.

A recent review of the data suggests that our nursing caregivers are particularly at risk, as a large portion of inpatient cases were coded with nursing as a Responsible Service.


These nursing-related cases are most frequently associated with the inability to provide consistent bedside care and/or monitoring. These failures correlate with resource and staffing shortages prevalent during the pandemic. Nursing providers were often unable to properly follow the policies and procedures in place, and many patients suffered with infections, fractures from falls, and pressure ulcers.


The data indicate other challenges when looking at all services involved with COVID-19 cases, such as inadequate patient assessments and provider communication issues. Such challenges further outline the limitations imposed on caregivers when delivering care in a high-stress clinical environment, such as in overwhelmed hospitals or overcrowded emergency rooms.


CRICO is deeply committed to working with its insured members to learn from the pandemic. The linkage of our data reflects the need to implement practices that better support nursing staff in delivering proper bedside care.

The data also clearly point to the necessity for more discussion around policy changes, nursing and provider support, and system preparedness: Do policies and procedures have amendments for qualifying events, such as the pandemic, that allow for a necessary shift to support the staff? Are there better options for communication challenges when the provider to patient ratio is at its max?

Our commitment to patient safety pushes us to be vigilant across the health care delivery landscape. We ensure the CRICO taxonomy is governed and updated correctly to successfully respond to the ebb and flow of this ever-developing industry. Observations from the new Linking and Weighting data give us the ability to do just that. These deeper insights provide a greater understanding of the specific aspects of health care delivery where we can learn and change more effectively.

To see Michelle Bondurant and Dr. Jonathan Einbinder’s recent presentation on this topic, “Generating Valuable Insights from Linking and Weighting Codes”—and a trove of other proprietary content drawn from Candello’s unique national data—click to apply for a personal membership in the Candello Community, for just $400 per year. And let the discoveries begin.

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Written By
Michelle Bondurant
Senior Data Coding Consultant, Candello
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