A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

Objective: This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM).

Design: We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices.

Setting: The survey was originally sent to 2136 hospitals in Germany and Switzerland.

Participants: Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%).

Intervention(s): None.

Main outcome measure(s): Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V.

Results: Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination.

Conclusions: This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward.