The article titled “Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study”, published in the British Journal of Anaesthesia (doi: 10.1016/j.bja.2025.04.047), presents the culmination of a large-scale European consensus initiative under the SAFEST project. Its objective was to formulate comprehensive, actionable, and evidence-based perioperative patient safety recommendations applicable across Europe.
The authors begin by acknowledging the high global prevalence of preventable harm in surgical settings. Although various guidelines exist, a pan-European consensus integrating diverse perspectives from surgery, anaesthesiology, nursing, public health, and patient organizations was lacking. This study fills that gap by employing a multimethod research design consisting of (1) a systematic review of 267 clinical guidelines, (2) extraction and synthesis of 4666 safety recommendations, (3) a two-round modified Delphi survey with a multidisciplinary panel, and (4) a face-to-face consensus conference.
The result is a final list of 101 perioperative patient safety recommendations (PPSRs) organized into 12 thematic areas, spanning the entire surgical continuum—preoperative, intraoperative, and postoperative phases. Each recommendation is evaluated in terms of importance, feasibility, level of evidence, and guideline quality. The recommendations cover tangible clinical practices (e.g., minimally invasive surgery, blood glucose monitoring), system-level policies (e.g., continuous audits, medication safety protocols), and patient-centred approaches (e.g., shared decision-making, tailored rehabilitation). Patient representatives actively participated in the consensus, influencing priorities particularly in communication, continuity of care, and engagement strategies.
The methodology was robust and transparent. The Delphi process ensured expert input from 66 panel members across 25 countries with diverse healthcare systems. The authors followed AGREE II for quality appraisal and CREDES guidelines for consensus methodology. Disparities between patients’ and professionals’ perceptions were quantitatively analyzed, revealing statistically significant differences in feasibility ratings of specific PPSRs—especially in areas like patient engagement and safety communication.
The SAFEST project also produced a visual “Patient Safety Compass” and technical/layman summaries to facilitate policy translation and implementation. The authors emphasize the adaptability of the PPSRs, suggesting that although they are tailored for European systems, their comprehensive nature and evidence foundation make them globally relevant.
This work has significant implications for healthcare policy, accreditation, and surgical safety governance. It provides a standardised yet flexible framework for enhancing patient safety culture and performance across heterogeneous clinical environments.
Reference:
Arnal-Velasco, D., Martinez-Nicolas, I., Fabregas, N., Bartakke, A., Calsbeek, H., Emond, Y., Groene, O., León, I., et al. (2025). Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study. British Journal of Anaesthesia. Advance online publication. https://doi.org/10.1016/j.bja.2025.04.047
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