Purpose The risk of adverse events in a hospital evaluation is an important process in healthcare management. It involves several technical, social, and economical aspects. The purpose of this paper is to propose an integrated approach to evaluate the risk of adverse events in the hospital sector. Design/methodology/approach This paper aims to provide a decision-making framework to evaluate hospital service. Three well-known methods are applied. More specifically are proposed the following methods: analytic hierarchy process (AHP), a structured technique for organizing and analyzing complex decisions, based on mathematics and psychology developed by Thomas L. Saaty in the 1970s; decision-making trial and evaluation laboratory (DEMATEL) to construct interrelations between criteria/factors and VIKOR method, a commonly used multiple-criteria decision analysis technique for determining a compromise solution and improving the quality of decision making. Findings The example provided has demonstrated that the proposed approach is an effective and useful tool to assess the risk of adverse events in the hospital sector. The results could help the hospital identify its high performance level and take appropriate measures in advance to prevent adverse events. The authors can conclude that the promising results obtained in applying the AHP–DEMATEL–VIKOR method suggest that the hybrid method can be used to create decision aids that it simplifies the shared decision-making process. Originality/value This paper presents a novel approach based on the integration of AHP, DEMATEL and VIKOR methods. The final aim is to propose a robust methodology to overcome disadvantages associated with each method.