Determinants influencing implementation of clinical risk management – Qualitative results of a national survey among clinical risk managers in Germany (KHaSiMiR21)

The improvement of patient safety requires management of clinical risks in hospitals. However, implementation status of clinical risk management (CRM) varies substantially across hospitals. Investigations into facilitators and barriers for effective implementation are thus necessary. Using an in-depth interview study with CRM experts in hospitals, this study aimed to investigate factors accountable for effective development and implementation status of CRM measures in Germany. As part of a nationwide survey, we conducted semi-standardized interviews with n = 10 selected clinical risk managers from general hospitals. We used qualitative content analysis to identify barriers and facilitators to the implementation of CRM. A broad range of determinants influencing CRM implementation were identified. Determinants were categorized into five thematic categories: general knowledge of CRM, safety culture, availability of resources, multi-level engagement and organizational structures. While numerous barriers to CRM implementation were identified, interviewees reported only a few supporting factors in comparison. Results suggest further challenges in effective CRM implementation and inform future research and implementation efforts.