Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep;135(3):723-736.
doi: 10.1016/j.bja.2025.04.047. Epub 2025 Jun 12.

Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study☆

Daniel Arnal-Velasco  1 , Ismael Martinez-Nicolas  2 , Neus Fabregas  3 , Ashish Bartakke  4 , Hiske Calsbeek  5 , Yvette Emond  5 , Oliver Groene  6 , Irene León  3 , Adam Žaludek  7 , Ana B Nunes  8 , Carola Orrego  9 , Kaja Põlluste  10 , Anna Rodriguez  11 , Yolanda Sanduende  12 , Willemijn Schäfer  13 , Javier Silva-García  14 , Victor Soria  15 , Paulo Sousa  8 , Claudia Valli  11 , Marieke Voshaar  16 , Maria Wittmann  17 , Pascal Garel  18 , Eva Romero  19 ; SAFEST Consortium; SAFEST Executive group; SAFEST Advisory group
Collaborators, Affiliations
Free article

Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study☆

Daniel Arnal-Velasco et al. Br J Anaesth. 2025 Sep.
Free article

Abstract

Background: Surgery-related adverse events are among the most common adverse events in-hospital. However, no comprehensive, multidisciplinary perioperative guidelines exist at the European level. The aim of this study is to describe the process and results in achieving European multidisciplinary consensus on perioperative patient safety recommendations.

Methods: This multimethod study included: (1) a systematic review of guidelines; (2) selection and synthesis of recommendations; and (3) a two-round modified Delphi technique including a 2-day face-to-face consensus conference. We recruited a panel of two expert groups balanced in terms of gender, geographical origin, and professional background, with meaningful participation from patient representatives. Consensus was defined as at least 70% of the panel rating a recommendation 7-9 on a 9-point Likert scale for importance to patient safety and feasibility of implementation.

Results: The systematic review included 267 guidelines, from which 4666 patient safety recommendations were identified and extracted. After four synthesis rounds, 99 recommendations were presented for the Delphi survey, detailing their strength of recommendation, level of evidence, and methodological quality of the cited guidelines. An expert group, composed of 66 multidisciplinary experts from 19 European countries, participated with a response rate of 80.3%. After the two Delphi rounds and the consensus conference, the panel agreed on a final set of 101 recommended perioperative patient safety practices.

Conclusions: A set of 101 comprehensive, evidence-based, patient-centred perioperative patient safety practices was developed through a European consensus process to improve the quality of care in healthcare facilities across Europe and beyond.

Keywords: evidence-based practice; medical errors patient safety; perioperative care; practice guidelines; quality; risk management; safety.

PubMed Disclaimer

Conflict of interest statement

Declarations of interest JB, TM, BM, and PVS participated and were explicitly presented as healthcare industry representatives. Additional to these potential conflicts of interest inherent to their affiliations, BM declared honoraria or consultation fees from Masimo International. EBV declared research funding from Vifor Pharma, Sysmex, Baxter. The rest of authors and collaborators have no relevant financial or non-financial interests to disclose.

Publication types