No.	Explanation
RM01	Comprehensive quality and/or risk management documentation (QM/RM documentation) is available QM-Handbuch (11.07.2022)
RM02	Regular further education and training measures
RM03	Employee surveys
RM04	Clinical emergency management Komplikationsmanagement und weitere mitgeltende Dokumente (11.03.2022)
RM05	Pain management Leitlinie postoperative Schmerztherapie und weitere mitgeltende Dokumente (04.11.2021)
RM06	Fall prophylaxis Pflegestandard Sturzprophylaxe und weitere mitgeltende Dokumente (09.06.2023)
RM07	Use of a standardised concept for pressure ulcer prophylaxis (e.g. “Expert Standard for Pressure Ulcer Prophylaxis in Nursing”) Pflegestandard Dekubitusprophylaxe und weitere mitgeltende Dokumente (23.11.2020)
RM08	Regulated handling of custodial measures Fixierung von Patienten (21.07.2022)
RM09	Regulated handling of occurring malfunctions of devices Wartung und Umgang Medizingeräte und weitere mitgeltende Dokumente (02.02.2022)
RM10	Structured implementation of interdisciplinary case discussions/conferences Case review conference Tumorkonferenzen Palliativbesprechungen Qualitätszirkel Multimodale Schmerztherapie
RM12	Use of standardised information sheets
RM13	Application of standardised surgical check lists
RM14	Preoperative summary of predictable critical surgical steps, surgical time and expected blood loss OP-Management und weitere mitgeltende Dokumente (04.01.2022)
RM15	Preoperative, complete presentation of necessary findings Fallbesprechung und weitere mitgeltende Dokumente (11.03.2022)
RM16	Procedure to avoid procedural and patient mix-ups Behandlungspfade und OP-Sicherheitscheckliste (08.04.2023)
RM17	Standards for recovery and postoperative care Intensivstation und Aufwachraum, weitere mitgeltende Dokumente (12.09.2020)
RM18	Discharge management Entlassmanagement und weitere mitgeltende Dokumente (06.05.2021)

Fault reporting systems

Internal to the institution

Conference committee

Conference frequency: jährlich

Measures

Zentraler Maßnahmenplan

No.	Explanation
IF01	Documentation and procedural instructions for handling the error reporting system are available As of: 09.12.2021
IF02	Internal evaluation of the received reports taken jährlich
IF03	Training of employees in handling the error reporting system and in implementing the findings from the error reporting system taken bei Bedarf

No.

Explanation

IF01

Documentation and procedural instructions for handling the error reporting system are available

As of: 09.12.2021

IF02

Internal evaluation of the received reports

taken jährlich

IF03

Training of employees in handling the error reporting system and in implementing the findings from the error reporting system

taken bei Bedarf

Across all institutions

Conference committee

Conference frequency: monatlich

No.	Explanation
EF01	CIRS AINS (Professional Association of German Anaesthetists and German Society for Anaesthesiology and Intensive Care Medicine, German Medical Association, National Association of Statutory Health Insurance Doctors)