Safety and risk management interventions in hospitals: a systematic review of the literature

The aim of this systematic review was (a) to synthesize the evidence on the effectiveness of detection, mitigation, and actions to reduce risks in hospitals and (b) to identify and describe components of interventions responsible for effectiveness. Thirteen literature databases were explored using a structured search and data extraction strategy. All included studies dealing with incident reporting described positive effects. Evidence regarding the effectiveness and efficiency of safety analysis is scarce. No studies on mitigation were included. The collected evidence on risk reduction concerns a variety of interventions to reduce medication errors, fall incidents, diagnostic errors, and adverse events in general. Most studies reported positive effects; however, interventions were often multifaceted, and it was difficult to disentangle their impact. This made it difficult to draw generic lessons from this body of research. More rigorous evaluations are needed, in particular, of continuous learning and safety analysis techniques.