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Volume 1 Supplement 1

Safety in Health

Success Factors of Clinical Risk Management - Measuring a Safety Index


The political, legal and insurance-related requirements for hospitals, out-patient treatment centers and other healthcare companies in Germany and European countries are constantly increasing. At the same time, however, evidence for the effectiveness and establishment of clinical measures for patient safety is becoming ever more important [1].

Since 1994, the GRB - Gesellschaft für Risiko-Beratung mbH has been providing advice to hospitals and other healthcare facilities on how to implement risk management measures in clinical processes in order to ensure a safe patient care. For quite a long time, the GRB has dealt with defining suitable parameters for patient safety. In the meantime, it has developed a model-based safety index, which enables a healthcare company to make the maturity level measurable.

Material and methods

Results from one of Germany's largest healthcare-loss databases and specifically developed claim-based prevention measures and performing safety and risk analyses in different specialist/service areas in healthcare companies serve as a basis for determining a safety index [2].

The development of the index aimed at measuring patient safety is based on the modified Swiss cheese model by Reason [3].

The following parameters are relevant for the calculation of the index:

1. Index-related prevention measures

2. Weighting of the potential risk in case that a prevention measure has not been fulfilled (severity of potential damage and probability of occurrence)

3. Fulfillment level of a prevention measure


The parameters described above are applied in a special formula. The index determines values between 0 and 100. 100 means maximum safety and 0 means maximum risk. The index can be determined after a safety and risk analysis for healthcare facilities. It can be ascertained for the examined area, in detail for accounted safety categories and as assessment comparison (Table 1).

Table 1 Overview: safety index after safety and risk analysis in surgery rooms including the interface anesthesia in three different clinics (Source riskala®GRB).


The index is an efficient instrument with which the safety profile of a healthcare company can be made transparent both internally and externally in accordance with the continuous process of improvement, and it can be used effectively for business management.


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  3. Reason J: Human error: models and management. British Medical Journal. 2000, 320 (7237): 768-770.

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Correspondence to Peter Gausmann.

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Competing interests

The authors have the following competing interests:

Employment relationship or executive position: Risk consultant Gesellschaft für Risiko-Beratung mbH, Detmold.

Consulting activity: Risk consultant for clinical risk management and risk-adjusted quality management systems in healthcare sector.

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Gausmann, P., Fleischer, M. Success Factors of Clinical Risk Management - Measuring a Safety Index. Saf Health 1 (Suppl 1), A19 (2015).

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