The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015

Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Trotz der zunehmenden Erkenntnis, dass es zur Bewältigung von Risiken in der Gesundheitsversorgung der Einführung systematischer Vorgehensweisen des Risikomanagements bedarf, gibt es bislang nur wenige Studien, die den Entwicklungsstand von klinischem Risikomanagement (kRM) auf nationaler Ebene untersuchen. Deshalb hat diese Studie zum Ziel, den aktuellen Entwicklungsstand des kRM in deutschen Krankenhäusern zu erheben und Unterschiede je nach Krankenhausart aufzudecken. Von März bis Juni 2015 wurden die für das kRM verantwortlichen Personen von 2.617 Krankenhäusern und Rehabilitationskliniken in Deutschland eingeladen, sich an einer Online-Befragung zum Entwicklungsstand verschieden