Background: Proactive involvement of patients in the design of safe care is a WHO-defined goal of the current decade. This paper investigated (a) which patient involvement activities and measures are implemented in German health care facilities for patient safety, and (b) which recommendations for action can be derived for our health care facilities. Aim and method: A literature and Internet search was conducted on institutional practices and organizational activities in Germany to improve patient safety with the involvement of patients. Interviews with five experts were conducted who advised our approach. An agenda for future research projects and first recommendations for clinical practice was formulated afterwards. Results: The evidence base on established measures to incorporate patient perspectives into the strategic promotion of patient safety in healthcare facilities in Germany is scarce and inconsistent. Patient surveys and the use of patient advocates are common. It remains unclear how patient councils as well as self-help groups have the potential to contribute to the promotion of patient safety in practice. Conclusions and agenda: An agenda is proposed. A more in-depth empirical survey and description of the situation in Germany, taking into account the experience of experts from clinical practice, is necessary to obtain a complete picture of the currently established measures for patient involvement, to uncover potential for realization and to define necessary framework conditions.