Development of a Core Outcome Set for Patient Safety in Perioperative Care: Insights from the SAFEST Project

Although surgical-related adverse effects are among the most common in-hospital adverse events, no set of indicators has yet been defined for a comprehensive and patient-centred analysis of this phenomenon. Thus, it is crucial to standardise a minimum set of indicators, a Core Outcome Set (COS), to allow for monitoring and evaluation of implemented patient safety best practices in perioperative care. The SAFEST project aimed to develop a relevant and feasible COS for patient safety in perioperative care, including patient-relevant data. Following a multimethod approach, an initial list of indicators (ILO) was developed by conducting an umbrella review on patient safety in perioperative care in surgical adult patients. The ILO was prioritised by a diverse group of experts, including patients, through a two-round eDelphi Technique, according to the importance and feasibility of each indicator. Exploring the challenges of measuring specific indicators, the same experts will define the final list of indicators in a consensus conference. From 588 indicators extracted in the umbrella review, 247 indicators were included in the ILO to be independently rated, on a 9-point Likert scale, by participating experts. The indicators were grouped by the perioperative period (preoperative, intraoperative, postoperative and mixed) and further subgrouped by Donabedian's quality of care conceptual model Structure - Process - Outcome. During the eDelphi process, some indicators were reworded, split, merged, added or removed, according to experts’ comments. The final set of indicators results is not yet available as this study is still undergoing. This COS contributes to enhancing standardised reporting in perioperative patient safety, allowing for benchmarking across EU countries and facilitating data comparison across studies.