Health care research is concerned with the observation, analysis, prognosis, assessment, further development and evaluation of routine care in the health sector. Patient safety aims to promote the safety of treatment and care processes in the healthcare system primarily through effective and efficient clinical risk management in healthcare institutions. Clinical risk management to promote patient safety requires observation, analysis, prognosis, assessment, further development and evaluation of the treatment processes. The interfaces between health services research and patient safety are obvious.

>> The Patient Safety Action Alliance (APS; www.aktionsbuendnis-patientensicherheit.de) is dedicated to promoting patient safety, particularly through recommendations for action, and assumes that strategies, methods and solutions for patient safety must be scientifically validated through high-quality healthcare research. Patient safety research can promote future good safety standards in healthcare practice (treatment and organization). In this respect, for the APS, patient safety and health services research are complementary tasks and exchange systems. At the institutional level, this mutual theoretical and practical condition is reflected in the close cooperation between the APS and the Institute for Patient Safety (IfPS; www.ifpsbonn.de): analysis of evidence, recommendations, recommendation evaluation, development of research approaches to patient safety (from methods of Evidence collection to patient safety indicators), improvement of recommendations - this is ideally how the process should be. The APS starts from concrete problems in everyday care and develops proposals for solutions based on them; It involves all disciplines and professional groups in the healthcare sector, incorporates their different expertise and practical experience and jointly develops suggestions and recommendations to improve patient safety. This approach offers the chance of practical suitability and high acceptance by users; In this way, as well as through testing after evaluation, improvement measures can be successfully and long-term anchored in everyday care.
The respective and joint work of APS and IfPS is characterized by interdisciplinarity, interprofessionalism and the concentration on treatment and care processes as well as their good organization. Good organization includes the technical, factual, personal and financial environment of processes and the impact on them, aims above all for their good management as well as for a motivation-promoting and sustainable development of the safety culture in the health care institutions.
The APS has worked out the following recommendations (E) for error prevention in the working groups since 2005:
• WG intervention mix-up (E + OP poster + flyer + brochure + PatInfo)
• AG patient identification (E)
• AG CIRS in the hospital (E + brochure)
• Working group on treatment error register (“core data set”)
• AG drug therapy safety
(Drug therapy safety checklist in the hospital; medication plan)
• Clean hands campaign (ongoing joint campaign)
• AG inform, advise, decide
• AG education and training
• AG Foreign bodies left in the surgical area
“Every swab counts” (E + Glossary)
• AG Medical Device-Associated Risks.

The IfPS has taken over the evaluation of some of these recommendations of the APS and has developed the first methodological approaches, which are based on "surrogate parameters" and will measure their effects in everyday healthcare practice. Using the example of the recommendation on mistaken interventions, it becomes clear that the ideal of evidence-based medicine, the randomized controlled trial, cannot be realized and therefore new types of study must be developed that can analyze the promotion of patient safety. What would have to meet with considerable doubts in clinical research can be well justified for health services research on patient safety.
Overall, from the point of view of the APS, error research in its departments of error analysis, error assessment and promotion of error reduction is a very important part of patient safety-oriented health care research. If it is also possible to intensify research into the effects of error prevention strategies and to evaluate their benefits and costs, health services research will make a contribution to patient safety that should not be underestimated.
Patient safety research as part of health services research is the basis for future good safety standards in healthcare practice. <<
by: Prof. Dr. Dieter Hart /
Dr. Günther Jonitz / Dipl. Soz. Sonja Barth

DKG: “Cultural Change”
As a founding member of the Patient Safety Action Alliance, the German Hospital Society (DKG) also supported the nationwide survey of the APS, which - according to DKG Managing Director Dr. med. Bernd Metzinger - for the first time presented reliable information on the situation of clinical risk management in Germany - by the way - said Metzinger in the congress opening press conference, something that the DKG does not see as its own task. According to Metzinger, the results could be impressive. The question of the implementation of specific measures alone would have shown that a cultural change in dealing with errors in German hospitals is now noticeable:
• 71% of the hospitals surveyed have concrete measures in place to prevent application errors in drug therapy;
• 85% conduct systematic MRSA screening of at-risk patients;
• 76% participate in clean hands campaign;
• 62% integrate the National Reference Center KISS;
• 94% have a systematic decubitus and wound management;
• 63% employ checklists during surgeries.