Risk Assessment Techniques and Risk Management Practices in Healthcare: A Comparative Survey of the United States and United Kingdom

Abstract Introduction and Aims Effective risk management is essential for improving patient safety, yet limited empirical evidence exists on how risk assessment techniques are used in routine healthcare practice. This study examines current risk management practices in healthcare organisations and compares approaches used in the United States (USA) and the United Kingdom (UK). Methods A survey of practising healthcare risk managers in both countries examined the use of risk assessment techniques and organisational risk management practices, including team composition and perceived organisational resources. A total of 160 risk managers from the USA and 40 from the UK, representing a wide range of clinical and administrative healthcare areas, participated in the study. Results Root Cause Analysis (RCA) was the most frequently used risk assessment technique in the USA, followed by Failure Modes and Effects Analysis (FMEA). In the UK, risk matrices were most commonly used, followed by Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. Risk managers in both countries preferred prospective risk management; however, organisational practice in the USA was reported to be significantly more retrospective. Approximately half of respondents reported insufficient organisational resources for effective risk management, most commonly limited time and staffing. In addition, only 43% of USA respondents and 47% of UK respondents reported that recommended risk improvement measures were implemented more than half of the time. Conclusions Healthcare risk management practices differ between the USA and the UK, particularly in the techniques used, organisational support, and the balance between prospective and retrospective approaches. Strengthening institutional support, increasing multidisciplinary participation, and expanding the use of structured prospective techniques may improve the effectiveness and maturity of healthcare risk management. Key Message (BMJ Requirement) What is already known on this topic? Empirical studies examining how risk management is conducted in healthcare organisations are limited. Most knowledge about healthcare risk management practice in the United States and the United Kingdom is inferred from guidelines or recommended best practices rather than from studies of actual practice. Evidence regarding risk management practice in UK healthcare institutions is particularly scarce. What this study adds This study provides empirical evidence on the current state of healthcare risk management practice in the USA and the UK. It identifies the risk assessment techniques most commonly used in healthcare organisations and examines how risk management activities are conducted. The findings highlight strengths and limitations in current practice and provide a comparative perspective on risk management approaches across the two healthcare systems. How this study might affect research, practice, or policy The study identifies several areas where healthcare risk management practice may be strengthened, including organisational support for risk management, multidisciplinary participation in risk assessment, and implementation of risk improvement measures. The findings also provide insight into the adoption of risk assessment techniques within healthcare, informing future research, policy development, and efforts to improve patient safety management practices.