[Development of clinical risk management in German hospitals]

Clinical risk management supports healthcare workers in recognizing, reducing, and managing risks in patient care. It is mandatory for all outpatient and inpatient facilities in the German healthcare system. The contents of the clinical risk management are regulated in the Social Code (Title 5), the guidelines of the Federal Joint Committee, the Patients' Rights Act, and the norms and recommendations of the Patient Safety Alliance. The Federal Joint Committee explicitly points out that minimum standards of risk management, error management, error reporting systems, complaint management in hospitals, and the use of checklists for surgical interventions must be implemented.The legislator requires that the effectiveness of the clinical risk management be checked regularly. Questionnaire surveys on clinical risk management in Germany show an overall positive development. However, the data are not sufficient for a comprehensive assessment. Methodologically reliable procedures should therefore be developed that check the status of the clinical risk management much more frequently and regularly. The data measuring structure, process, and outcome should be collected systematically and presented in a comparative manner in relation to the facilities.Opportunities for clinical risk management arise from the World Health Organization's Global Action Safety Plan, advances in digitization, the integration of clinical risk management into organizational risk management, and the improvement of structural quality. Clinical risk management must be given even more space in the daily routine of doctors and nurses. This requires competence and human resources in this area. These are not sufficiently available in German hospitals.