title: The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: University Hospital Bonn, Institute for Patient Safety, Bonn, Germany. Electronic address: tanja.manser@ukb.uni-bonn.de.
authors: Tanja
authors: T
authors: Manser
authors: University Hospital Bonn, Institute for Patient Safety, Bonn, Germany.
authors: Janina
authors: J
authors: Frings
authors: University Hospital Bonn, Institute for Patient Safety, Bonn, Germany.
authors: Gregory
authors: G
authors: Heuser
authors: University Hospital Bonn, Institute for Patient Safety, Bonn, Germany.
authors: Fiona
authors: F
authors: Mc Dermott
mesh_terms: D005858:Germany; D006761:Hospitals / Q000592:standards*; D006801:Humans; D018570:Risk Assessment; D012308:Risk Management; D011795:Surveys and Questionnaires
keywords: Clinical risk management; Critical Incident Reporting; Implementierungsgrad; Klinisches Risikomanagement; Patientensicherheit; critical incident reporting; implementation; national survey; nationale Befragung; patient safety