Enterprise Risk Management and Patient Safety in War-Torn Healthcare Systems: A Cross-Sectional Study in Yemeni Referral Hospitals

Background: Medical errors in public hospitals are increasingly viewed as reflections of administrative systemic fragility rather than isolated clinical lapses. This is particularly evident in healthcare environments operating under sustained operational pressure and resource scarcity. Objective: This study aimed to explore the correlation between health risk management practices and the control of medical errors in three major public hospitals in Sana'a (Al-Thawra Modern General Hospital Authority, Al-Gomhouri Teaching Hospital, and Al-Kuwait University Hospital) during the year 2023. Methodology: Utilizing a quantitative cross-sectional design (N=240), the study assessed risk management implementation across five dimensions. Results: Findings revealed a moderate level of risk management implementation (M = 3.42), characterized by a critical dichotomy: while staff demonstrated high "Risk Awareness" (M = 3.68), practices regarding "Systematic Incident Investigation" were notably low (M = 3.18). Pearson correlation analysis confirmed a strong, statistically significant positive relationship between risk management maturity and medical error control (r = 0.53, p < 0.001). Multiple regression modeling explained 36% of the variance in patient safety outcomes (R^2 = 0.36), identifying "Leadership Support" and "Reporting Systems" as the strongest predictors of safety performance. Conclusion: The study concludes that an urgent transition toward Enterprise Risk Management (ERM) and the adoption of High Reliability Organization (HRO) principles are essential. It advocates for institutionalizing risk management as a permanent administrative function and fostering a non-punitive culture to encourage the reporting of near-misses.