[Quality assurance and risk management in gynecology and obstetrics]

A glance through the relevant supreme court cases of the last five years will conclusively reveal that obstetrics is currently the sector with the largest number of liability claims, despite the fact that German obstetrics hold a leading world position. This high risk entails high insurance premiums, which can threaten the existence of those exercising the profession and which can therefore not be increased indefinitely. Thus the causes of these exploding liability claims in the medical sector have to be combated, i.e. the origins of damage have to be tracked down in order to identify and eliminate or at least reduce the risks. This future-oriented approach of damage prevention is known as risk management, and entails almost complete elimination not so much of maltreatment but most certainly of deficiencies in information, organisation and documentation as well as equipment. Seen from this point of view, risk management represents a form of quality control based on relevant judicature and statutory provisions. American experience shows that risk management activities are indispensable today, and that only proactive and preventive risk control, as opposed to limited reactive risk control, is capable of stemming the flood of liability claims in the medical sector.