INTRODUCTION AND AIM

Previous initiatives have addressed patient safety in surgical care in Europe, but most of them have been focused on the intraoperative period.

We aimed to reach a Europe-wide consensus on Perioperative Patient Safety Standardized Practices (PPSSP) as part of the Horizon Europe “Improving quality and patient SAFEty in surgical care through STandardisation and harmonisation of perioperative care in Europe (SAFEST)”.

METHOD

An international expert panel from 22 European countries. Balanced representation of geographical location, clinical and non-clinical expertise, and gender.

An online two-round modified-Delphi, populated with patient safety recommendations extracted from a systematic review of guidelines (CRD42022347449).

The perioperative patient safety standardized practices (99 in 1st round, 104 in 2nd round) were rated on relevance and feasibility in the following Likert scale:

 "Very strongly disagree; Strongly disagree; Disagree; Slightly disagree; Nor disagree or agree; Slightly agree; Agree; Strongly agree; Very strongly disagree." 

Consensus agreement: at least 70% in the three higher ratings (“Agree” to “Very strongly agree”).

Finally, a 2-days in-person meeting was held in March 2023 in Brussels. This Consensus Conference was organized in several thematic sessions that provided final considerations on Finetuning, Patient perspective, Equity, Feasibility, and Implementation issues.

RESULTS

53 full responses were received after the 2nd round. From them, 52.8% were females, and 5 (9.4%) were patient representatives. The most represented group was anaesthesiologists (34.0%), followed by surgeons (13.2%).

Regarding PPSSP, 102 out of 104 reached consensus on relevance, although 20 did not reach consensus on feasibility.

Among the highest rated on relevance were the use of surgical safety checklists, identification of patients in different processes of care, hand hygiene, verification of equipment, and the development of a strong safety culture.

The top-three most feasible were those related to hand hygiene, verification of anaesthesia equipment, and patient identification.

During the Consensus Conference some final rewordings were suggested and three PPSSP were dropped from the final list. From the patients’ perspective, three areas were highlighted: Continuity of care; Patient engagement; and Accessible patient information. Finally, considerations about equity, feasibility and evidence emerged and were considered as overarching topics that will be part of an ulterior manuscript.

CONCLUSIONS

The 101 SAFEST Perioperative Patient Safety Standard Practices are a comprehensive, evidence-based, patient-centred list of recommendations to improve quality of care along hospitals in Europe and beyond.

The list has reached consensus through a European-wide process of a balanced expert group that included all stakeholders of the entire perioperative period with a special emphasis on patient participation.

REFERENCES