How Can Hospitals Make Surgery Safer? Putting 101 Consensus Safety Practices to Work
Problems related to surgery are among the most common adverse events patients experience in the hospital. So how can a hospital, a surgical team and a patient make surgery safer? Safe surgery depends on many people doing many small things right across the whole perioperative period (before, during and after surgery). A 2025 study in the British Journal of Anaesthesia describes how a European group agreed on a shared set of safety practices that cuts across specialties.
This summary is based on the published abstract. Read the abstract on PubMed
What the authors did
The project had three parts: a systematic review of existing guidelines, selection and synthesis of their patient safety recommendations, and a two-round modified Delphi process followed by a two-day, in-person consensus conference. The panel was balanced by gender, country and professional background, with meaningful participation from patient representatives. A recommendation reached consensus if at least 70% of the panel rated it 7 to 9 on a 9-point scale, both for importance to patient safety and for feasibility of implementation.
What they found
- Starting point: 267 guidelines containing 4,666 patient safety recommendations.
- Narrowing down: after four synthesis rounds, 99 recommendations went to the Delphi survey, each with its strength of recommendation, level of evidence and source-guideline quality.
- The panel: 66 multidisciplinary experts from 19 European countries, with a response rate of 80.3%.
- The result: a final set of 101 recommended perioperative patient safety practices.
The authors describe the set as comprehensive, evidence-based and patient-centred, intended to improve quality of care across Europe and beyond.
Limitations
The abstract describes the process but not the content of each practice, so this summary cannot list them. Consensus reflects panel judgment, and the abstract does not report whether using the set improves outcomes. Practices agreed for European systems may need local adaptation.
Safety takeaways: how to make surgery safer
For hospitals and safety leaders
- Run a gap analysis. Compare current perioperative routines against the full published set and identify which practices are missing or inconsistent.
- Prioritize what is feasible. Every practice was rated both important and practical, so start with changes your teams can put in place and sustain.
- Turn recommendations into local protocols. Assign clear owners, train staff and check adoption over time.
For surgical, anesthesia and nursing teams
- Treat safety as a team system. Safer surgery comes from many practices working together across the whole surgical journey, not from one step or one person.
- Make it easy to speak up. Encourage any team member, and the patient, to raise a concern without hesitation.
For patients and families
- Be part of the safety team. Patient representatives helped shape this list, which reflects the value of the patient's view.
- Prepare before surgery. Bring a complete list of medicines and allergies, and ask what will happen before, during and after the procedure.
- Speak up. If something seems wrong or different from what you were told, say so.
Reference
- Arnal-Velasco D, Martinez-Nicolas I, Fabregas N, Bartakke A, Calsbeek H, Emond Y, et al; SAFEST Consortium. Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study. Br J Anaesth. 2025 Sep;135(3):723-736. doi:10.1016/j.bja.2025.04.047. PMID: 40514281. PubMed: https://pubmed.ncbi.nlm.nih.gov/40514281/
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This article is educational information, not legal or medical advice.
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