PARS program

The Patient Advocacy Reporting System® (PARS) Program

In 1989, a Vanderbilt research team led by Professor Frank Sloan published a study indicating that malpractice experience was not randomly distributed and a small subset of physicians by specialty (2-8%) were associated with a disproportionate share of claims and payouts.  Results prompted a series of studies by Vanderbilt researchers and colleagues that focused on the "why".  Findings indicated claims experience was consistent over time, high risk today predicts high risk tomorrow, and that experience, although influenced by specialty, was not linked to the complexity of care delivered.  Research led by Dr. Gerald Hickson also found that high claims risk-physicians were perceived by patients and families as disrespectful. 

Study results led to the creation of the Patient Advocacy Reporting System based on the premise that patient and family observations and experiences reported (unsolicited) to an Office of Patient Affairs, when coded and aggregated, identify high-risk clinicians and support intervention. 

Subsequent research revealed that not only are physicians who model disrespect at increased malpractice claims risk, the patients who seek care from those same physicians are at elevated risk for avoidable surgical and medical complications. 


  1. Supports healthcare organizations as they pursue professionalism, safety, risk prevention, and patient satisfaction;
  2. Provide national patient relations benchmarks that promote best practices in collecting and documenting patient and family observations and best practices in service recovery; 
  3. Establish system-wide surveillance for behaviors that undermine a culture of safety and respect; 
  4. Train peers and leaders to effectively deliver messages to colleagues; 
  5. Provide ongoing support based on 20+ years of experience to leaders as they address challenges in pursuit of professionalism within their teams. 

Through PARS, CPPA delivers national, discipline-specific, peer-comparative benchmarks for effective peer-delivered interventions that support improvements in care delivery. For example, the figure below shows a high-risk physician’s rank (represented by the dots) relative to all active physicians in the PARS database (the white line) and to physicians within their specialty (the blue line).

CPPA’s data also yield sub-specialty comparisons, such as individualized graphs of orthopedic sub-specialists in spine, ankle, shoulder, or wrist surgery. CPPA similarly benchmarks other specialties and their subspecialties.