Analyse der Implementierung und Nutzung von Fehlermeldesystemen in deutschen Universitätskliniken: Ergebnisse einer querschnittlichen Online-Befragung

Abstract

Background

Critical incident reporting systems (CIRS) are a central component for ensuring patient safety and an essential tool in risk management at German university hospitals. Despite their widespread use, there are still considerable challenges with regard to their practical application and effectiveness. The aim of this study is to analyze the dissemination and use of such systems and the associated barriers in order to identify potential for optimization.

Methods

A cross-sectional online survey was conducted among all German university hospitals (n = 38) between August and September 2024. Both structural and process-related variables were recorded, supplemented by selected aspects of the WHO CIRS self-assessment. The data was analyzed descriptively using SPSS® Statistics Version 29, supported by graphical representation using GrapPad Prism 9®.

Results

Of the 38 university hospitals contacted, 14 participated (36.8%). All participating university hospitals use internal critical incident reporting systems. 92.9% forward reports to cross-institutional systems, with 92.3% of the university hospitals forwarding less than 10% of the reports. Most university hospitals (11) evaluate ≥ 90% of incoming reports, ten hospitals do not use standardized analysis specifications. Feedback to reporting persons is provided in eight out of 14 university hospitals. The WHO self-assessment showed deficits in the implementation of personalized feedback and clear criteria.

Conclusion

Despite the widespread use of critical incident reporting systems, the results reveal a clear optimization potential in the standardization of analysis processes, the prompt processing of reports and feedback mechanisms. The low transfer of reports to cross-institutional systems indicates structural and organizational barriers that need to be addressed. These findings provide important insights to support the further development of incident reporting systems and thus improve both patient safety and risk management.