"Every accident is an indicator that something is wrong with men, methods, or material. Investigate and then improve.”

Photo by Günter Valda on Unsplash


Patient harm due to adverse events is among the top 10 causes of death and disability across the world. Medication error alone was responsible for over 350,000 deaths in the United States of America in 2018. Compare this to the safety record of aviation, which boasted a 0.1 death per 12 billion miles flown between 2000 and 2018.

Placing the blame for adverse medical outcomes on a single individual is misplaced in the vast majority of all cases. Instead, accident causation more often is systemic and a result of a chain of errors, false diagnostics, wrong indications, and poorly executed therapy. Improving the management of the process chains can, thus, contribute to reducing the errors at multiple chain links and, finally, to minimizing harm to the patients.

Hospital safety management, therefore, plays a crucial role in improving the medical and economic performance of patient care. Hence, the participants will be equipped with a set of measurements to encounter risks before they manifest.

Safety, on the other hand, should also be a maxim for the handling of the clinical personnel. The nurses` and physicians` health, as well as their job security, play a leading role in first assessing the employer’s quality of the hospital and second the care providers` willingness to provide top performance on the job. There is evidence that people perform much better (+50%) and experience less stress (-74%) in high-trust environments [Zak PJ, HBM, 05/2017]. Best-selling author and Utah State University professor Stephen R. Covey put this correlation into a simple formula: “When the trust account is high, communication is easy, instant, and effective.”

And since the performance in healthcare significantly relies on human interactions and communication, creating a safe hospital is a prerequisite for excellent medical and economic outcomes.

In this module, we propose measures to create a maximum degree of safety not only for the sake of the patients but for the personnel, too.


We initiate the module with a collection of the participants` most pressing safety concerns. This discussion will be structured through the setting of safety dimensions/categories first. Our individualized approach aims to customize the content of the following chapters to the actual needs of the participants, who eventually are invited to craft their specific safety-measures-handbook in the workshop chapter of this module.

Therefore, experiences from different participants from different hospitals will enrich the other participants` arsenal to combat hospital risks for both the patients and the personnel.


Hospitals are intrinsically dangerous, not least due to their immense complexity. We evaluate the causal factors that are responsible for this complexity and the subsequent risks for patients. In this view, we identify the safety limitations in hospitals across the outpatient, in-patient, intensive care unit, and operating theatre settings from diagnostics to therapy.

Adverse events are often attributed to time-constraints in the daily routine, overconfidence of the care providers, communication flaws, technical issues, inadequate resources, and highly complex comorbidities. For that reason, we set impulses for an efficient time-management, continuous self-controlling, a positive and error-embracing corporate culture, as well as a systematic personnel development with each hospital`s specific foci.

Overall, we emphasize the importance of aligning all hospital`s stakeholders like patients, relatives, doctors, and nurses. It is this module’s goal to enable the participants to capitalize on the trust-performance correlation in their hospitals.


Lucid examples from Hannover Medical School in Germany, and from hospitals in the Indian sub-continent are given to showcase the application of the theoretical framework of safety improvement measures. We show practical measures to illustrate the role of job security in hospital safety and performance, how to establish predictive and reliable routines, and why and how to establish long-term relationships with referring physicians.

Additionally, practical tips and ideas for patient engagement, which had a significant positive impact on safety and costs are introduced. Moreover, technology can play a key role in hospital safety. Participants will be exposed to the deployment of information technology resources that promote patient engagement and, consequently, safety.

Advances in the area of artificial intelligence in population health and diagnosis will also be discussed. Of course, parallels to the aviation industry cannot be missed in this module.


Participants will be encouraged to draft their personal 360-day-hospital-safety-progamme. The acquired knowledge and the examples form the showcase chapter, in combination with the discussion with other participants, will broaden each participant’s perspective on his or her hospital`s safety.

The participants will outline the risks in different areas in their hospital and define suitable key performance parameters to assess relevant safety items. Every safety measure should be timed and evaluated according to stipulated milestones. So, the participants will be supported in building a feasible timetable for their safety-programme.

Finally, it is essential to communicate the safety issues, measures, and improvements to the team and stakeholders to keep up the sense of urgency for hospital safety and maintain the stakeholders` engagement. A communication plan completes the 360-days-safety-programme.