Risk management has been identified as an important way to decrease medical errors and to improve overall quality of care in US hospitals. This literature review attempts to understand the current state of risk management practices and approaches of US hospitals. This review was performed to explore the extent to which risk management systems in hospitals have the tools, resources and staffing appropriate to handle and improve risk management. These findings may be used to better understand current and best practices in US hospitals, and to further base policy recommendations that might improve those systems.