Abstracts by keywords: Patient Safety
Whistleblower-Gaslighting als Prüfstein für Governance, Qualitätsmanagement und Aufsicht im Gesundheitswesen
01.06.2026
Speak-up ist Frühwarnsystem: Hinweise auf Risiken, Abweichungen und unklare Verantwortlichkeiten ermöglichen Lernen, Prävention und sichere Versorgung. In der Versorgungsrealität hierarchischer Systeme erleben Mitarbeitende jedoch immer wieder, dass Hinweise nicht nur unbeachtet bleiben, sondern aktiv umgedeutet werden – bis hin zur Infragestellung von Kompetenz, Motiven oder Stabilität der meldenden Person. Zusätzlich zu allgemeinen psychischen Mechanismen wirkt im Arbeitskontext ein reales Machtgefälle: Arbeitgebende verfügen rechtlich und organisatorisch über Weisungs-, Bewertungs- und Sanktionsmöglichkeiten, die Deutungsmacht und Abhängigkeiten verstärken. In belasteten Konstellationen können sich diese Asymmetrien psychodynamisch überlagern (z. B. durch Elternübertragungen auf Autoritätsfiguren), was Speak-up weiter erschweren kann. Ergänzend gilt: Auch Patientenbeteiligung wird als wichtiger Baustein der Patientensicherheitsarbeit beschrieben (Koch et al. 2023). Für solche Muster verwenden wir den Begriff Whistleblower-Gaslighting: eine Form systematischer Verunsicherung, die die eigene Urteilskraft unterminiert (Abramson 2014) und Zeugenschaft entwertet (Spear 2019). Im Unterschied zu fairer, evidenzbasierter Kritik entsteht dabei keine überprüfbare Klärung; stattdessen verschiebt sich der Fokus von der Sache auf die Person. In Deutschland verstärkt der Fokus auf Hinweisgeberschutz und Compliance (HinSchG) den Handlungsdruck: Wenn ein Meldekanal formal vorhanden ist, informell aber Sanktionserwartungen bestehen, kippt Speak-up in Schweigen und Pseudo-Compliance – formale Konformität ohne verlässliche Umsetzung im Versorgungsalltag. Ziel dieses Beitrags ist eine kompakte, praxisnahe Orientierung: (1) begriffliche Schärfung und Abgrenzung, (2) Mechanismen und typische Risikomuster, (3) konkrete Unterbrechungspunkte für Führung, Qualitätsmanagement und Teams.
05.04.2026
Patientensicherheit ist ein zentrales Ziel moderner Gesundheitssysteme, dennoch treten weiterhin viele vermeidbare Ereignisse auf. Ein wenig genutzter Ansatz ist die Einbindung von Patientenbeiräten (PBR) auf organisationaler Ebene, die durch Erfahrung und Außensicht wichtige Impulse für Sicherheitsprozesse liefern. In vier Teilstudien des PEPS-Projekts wurden Bedarfe erhoben, internationale Ansätze gesichtet, ein Schulungsprogramm („Partners for Patient Safety“, P4PS) entwickelt und dessen Akzeptanz sowie Machbarkeit evaluiert. Die Ergebnisse zeigen: PBR werden meist informativ oder konsultativ eingebunden, benötigen jedoch Kompetenzen in Patientensicherheit, Kommunikation und Qualitätsmanagement. Das P4PS-Programm zeigt Machbarkeit und Wirksamkeit auf, sodass Schulungen die Rolle der Patientenvertretenden transformieren können – von reiner Erfahrung hin zur multikompetenten Beratung, die Lebenswelt und Systemlogik verbindet. Auf Basis der Ergebnisse und eines partizipativen Strategiedialogs wurden gemeinsam mit Projektteilnehmenden praxisnahe Handlungsempfehlungen für Gesundheitseinrichtungen, PBR und Systemakteure entwickelt. Zentrale Forderung ist die verbindliche Integration von PBR in sicherheitsrelevante Prozesse, unterstützt durch Ressourcen, klare Rollen und gemeinsame Fortbildungen. So kann Patientenbeteiligung von symbolischer zu strategischer Partnerschaft weiterentwickelt werden.
31.01.2026
Patient safety is one of the highest goals of healthcare and, since 2022, the tenth national health goal in Germany. Care errors contribute significantly to temporary or permanent impairment, prolonged hospital stays, or even death of patients. Although the topic has received considerable attention in the USA since the publication of "To err is human" in 2000, there remains a significant need for action. Adverse events triggered in the treatment context cannot be completely prevented given the complexity of medical treatments and the range of patient pre-existing health conditions. Strategies to improve the quality of care therefore focus on preventing avoidable adverse events. These are defined as those that would not occur if current medical standards were adhered to. The Patient Safety Action Alliance (APS), an alliance of representatives of healthcare professions, institutions, associations, and patient organizations, has been committed to implementing strategies to prevent adverse events since its founding in 2005. Treatment errors usually occur within complex and collaborative contexts. Against this backdrop, the APS considers collaborative learning from mistakes to be the most important tool for improving patient safety [1]. To enable and successfully implement this, open communication is essential.
04.12.2023
Patient safety in healthcare has increasingly become the focus of global attention. It is defined as the "avoidance, prevention, and improvement of adverse events or injuries resulting from healthcare processes" (Campbell et al., 2020). At the 74th World Health Assembly (2021), the World Health Organization (WHO) presented a global action plan to prevent health threats and harm to patients arising from healthcare (World Health Organization, 2021). Strategic Goal 4 of this action plan explicitly calls for active patient involvement (PD) in the further development of healthcare. Given the continued significant number of preventable adverse events in medical healthcare, even in Germany, the tenth National Health Goal on Patient Safety was established in 2022 (Holtz & Jonitz, 2023). This goal also calls for the active involvement of patients, their relatives, or representatives, e.g., through the use of appropriate tools. B. by promoting patient safety competence and supporting patients in their active participation in the development of measures.
04.12.2023
Many topics that have dominated the health policy discussion in Germany and internationally in recent years have been pushed into an almost distant background due to the Corona crisis1. Quality orientation as a central paradigm - who is still aware of the intensity with which the quality offensive was discussed in the middle of the last decade, the patient safety issue was at the forefront, competitive elements such as pay for performance heated up emotions, patient autonomy was held up as the greatest asset and the patient -Reported outcomes were celebrated as cornerstones of quality measurement. Perhaps the most difficult task today is to restore continuity between the present determined by Corona and the themes of this seemingly distant past. Not everything can have been wrong, but on the other hand, it must be recognized that Corona has meant that some of the assumptions and certainties from just a year and a half ago that were considered unchangeable require intensive discussion and addition. The present text can only outline the problem and present a work program based on a few examples. A detailed derivation of the conceptual consequences based on the previous findings from the corona pandemic and the technical and scientific foundations of the quality and safety discussion of the last decades must be reserved for the in-depth discussion in the next few years and will take on a considerably larger scope.ckende Acute diseases such as stroke and myocardial infarction are documented less frequently. The behavioral change that resulted from the implementation of strict hygiene rules may also have led to a “real” decrease in the rates of non-Covid-19 infectious diseases (5,6). In other words, the measures taken to combat the Covid-19 pandemic may also have influenced the spread of other germs that cause respiratory tract infections (AI) and gastrointestinal infections (GI). For this reason, in the present study the authors wanted to investigate the frequency of these AI and GI during the Covid-19 pandemic using data from a large database that includes anonymized treatment information from general practitioners and pediatricians in Germany.
28.01.2022
A systematic review with meta-analysis based on randomized and non-randomized studies. Ensuring comprehensive, highly specialized medical care is a current health policy issue in Germany (1). Innovative care models are required, especially in structurally weak regions, to ensure specialist medical care (2). But new treatment concepts are also required for the exchange of relevant patient data from highly specialized medical disciplines, such as patients with rare diseases, in order to be able to make and communicate treatment decisions in a timely manner (3). Telemedicine applications promise the possibility of overcoming these hurdles and ensuring patients receive the medical care they need (4).
22.01.2017
The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life in improving patient safety. The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life when improving patient safety.