Politique nationale de gestion des risques en établissements de santé

In France, the health safety concerns gradually appeared in the legislations. In ten years health safety has become a major component in the health policy. The ministry in charge of health therefore whished to submit to the hospitals a procedure and the main principles for setting up a risk management programme. The recommendations published in March 2004 are part of the scope of the reflection on improving the quality and safety in hospitals. They develop the operational aspects of a risk management procedure by stating the different steps in the setting up and running of a risk management programme. These recommendations mostly concern the clinical risk management as well as the technical and environmental risk management if the patients' and the personnel's' safety and the continuity of medical care are at stake. Setting up a global and coordinated risk management that meets the recommendations will require important changes for the hospital staff: modifications of the practices, of the individual and collective behaviours and of the decision and involvement modes for each protagonist. A long-lasting common vigilance and safety culture must be developed in order to enable these changes.