Transforming perioperative patient safety clinical guidelines recommendations into measurable standards: insights from the SAFEST project

Adopting evidence-based practices can improve the safety outcomes of surgical care. However, translating evidence into practice is slow in the healthcare field; an effort should be made to overcome this challenge. One approach could be to develop measurable standards to allow the evaluation and prioritization of healthcare improvements. The SAFEST project aimed to transform a list of prioritized clinical guidelines recommendations for adults’ perioperative care into measurable standardized practices (or standards) for hospitals to implement along the perioperative patient journey. Based on a previous systematic review of guidelines and an international expert panel review, we transformed recommendations into standards through an iterative and consensus qualitative approach. First, recommendations were classified according to the perioperative period (pre, intra or post) and based on predefined clinical areas. Second, one or more recommendations were transformed into one standard. Third, for each standard, measurable elements were developed to highlight in practical terms what needs to be implemented and measured, and the source of information and responsible stakeholder were identified. The overall transformation was performed by independent reviewers and the list of measurable standards was approved and finalized through discussion. From an initial list of 101 prioritized clinical practices recommendations, we developed 103 standards with 164 measurable elements. The standards with the related measurable elements, classified based on the perioperative period, were grouped in 12 different areas based on specific topic (e.g., complications preventions). Overall, these measurable standards can enhance dissemination and implementation of patient safety standardized practices in the continuum of care for adults’ patients undergoing surgery.