Objectives: To develop a consensus-based EU-wide Core Measure Set (CMS), including patient-reported measures, for evaluating perioperative patient safety in routine adult care.
Methods: A four-phase approach was applied: 1) identification of candidate structure, process, and outcome measures through three literature reviews; 2) synthesis into an initial list via deduplication and merging; 3) consensus process using a two-round modified eDelphi technique, with subject-matter and lived-experienced experts rating the importance and feasibility of each measure (consensus: =75% rating 7-9, =15% rating 1-3), followed by an online Consensus Conference addressing measures highly valued by patients but lacking feasibility consensus; 4) refinement of the CMS for patient safety in perioperative care (CMS-PSPC).
Results: Out of 9,717 records identified, 340 studies were included, yielding 1,305 measures. After refinement, 247 measures were consolidated; 84 reached consensus, and ten more were added via the Consensus Conference. The final CMS-PSPC comprised 76 measures: 22 outcome, 18 process, and 36 structure measures.
Conclusion: The CMS-PSPC provides a standardised, patient-centred framework for evaluating, monitoring and benchmarking perioperative patient safety in routine clinical care, supporting EU-wide quality improvement efforts.
Keywords: core measure set; core outcome set; outcome assessment; patient safety; performance measures; perioperative care; quality indicators; routine care evaluation.
Ana Beatriz Nunes 1 , José Pedro Teixeira 1 , Andreia Leite 1 2 , Willemijn Schäfer 3 , Claudia Valli 4 5 , Ismael Martínez-Nicolas 6 7 , Margarida Paixão 8 , Ayshe Seyfulayeva 1 , Daniel Treviño Abelenda 4 , Anna Rodríguez 4 5 , Pedro Casaca Carvalho 1 , Anita Heideveld-Chevalking 9 , Yvette Emond 10 , Kaja Põlluste 11 , Hiske Calsbeek 10 , Daniel Arnal-Velasco 6 12 , Adam Žaludek 13 14 , Pascal Garel 15 , Cordula Wagner 16 17 , Oliver Groene 18 19 , Carola Orrego 4 5 20 , Paulo Sousa 1 ; SAFEST Scientific Advisory Group; SAFEST Scientific Executive Group; SAFEST Consortium
Disease Category: Public health
Disease Name: Perioperative medicine
Age Range: 18 - 120
Sex: Either
Nature of Intervention: Surgery
- Clinical experts
- Conference participants
- Consumers (caregivers)
- Consumers (patients)
- Governmental agencies
- Guideline developers
- Methodologists
- Patient/ support group representatives
- Policy makers
- Researchers
- Private sector representatives
- Service providers
- Service users
- Regulatory agency representatives
- COS for practice
- Consensus conference
- Delphi process
- Literature review
- Nominal group technique (NGT)
We aim to develop a Core Outcome Set (COS) for patient safety in perioperative care, following a multimethod approach based on COS-STAD recommendations: 1) An initial list of outcomes (ILO) will be developed by conducting an umbrella review of outcomes and outcome measurement instruments on patient safety in perioperative care in surgical adult patients, complemented by outcomes identified in a systematic review of Clinical Practice Guidelines and a systematic review of successful interventions directed at reducing adverse events in surgical care; 2) the ILO will be prioritised, by relevant stakeholders, in a two-round eDelphi process, incorporating additional outcomes identified by participants in round one of the eDelphi into round two; 3) a final list of outcomes will be defined in a consensus conference, where the relevant stakeholders, including patients, will be invited to discuss the results from the eDelphi using a modified nominal group technique; 4) the COS for patient safety in perioperative care will be finalised by the researchers and reported according to COS-STAR guidance.