ORIGINAL ARTICLE
Int. J. Public Health
Core Measure Set for Patient Safety in Perioperative Care: A Clinical Practice-Oriented Consensus Study
- AB
Ana Beatriz Nunes 1
- JP
José Pedro Teixeira 1
- AL
Andreia Leite 1,2
- WS
Willemijn Schäfer 3
- CV
Claudia Valli 4,5
- IM
Ismael Martínez-Nicolas 6,7
- MP
Margarida Paixão 8
- AS
Ayshe Seyfulayeva 9
- DT
Daniel Treviño Abelenda 4
- AR
Anna Rodríguez 4,5
- PC
Pedro Casaca Carvalho 1
- AH
Anita Heideveld-Chevalking 10
- YE
Yvette Emond 11
- KP
Kaja Põlluste 12
- HC
Hiske Calsbeek 11
- DA
Daniel Arnal-Velasco 6,13
- AŽ
Adam Žaludek 14,15
- PG
Pascal Garel 16
- CW
Cordula Wagner 17,18
- OG
Oliver Groene 19,20
- CO
Carola Orrego 4,5,21
- PS
Paulo Sousa 1
- SS
SAFEST Scientific Advisory Group 22
- SS
SAFEST Scientific Executive Group 4
- SC
SAFEST Consortium 4
1. NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, Lisbon, Portugal
2. Departamento de Epidemiologia, Instituto Nacional de Saude Doutor Ricardo Jorge, Lisbon, Portugal
3. Northwestern Quality Improvement, Research & Education in Surgery, Department of Surgery, Northwestern University Department of Medical Social Sciences, Chicago, United States
4. Institut Avedis Donabedian Universitat Autonoma de Barcelona, Barcelona, Spain
5. Universitat Autonoma de Barcelona, Barcelona, Spain
6. SENSAR, Alcorcón, Spain
7. Institute for Biomedical Research of Murcia, FFIS-IMIB Pascual Parrilla, Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia, Murcia, Spain
8. Public Health Unit Francisco George, Unidade Local de Saude Santa Maria, Lisbon, Portugal
9. Amsterdam Public Health Research Institute, Amsterdam, Netherlands
10. Operating Theatres, centre of Acute and Intensive Care, Radboud universitair medisch centrum, Nijmegen, Netherlands
11. IQ Health scientific department, Radboud universitair medisch centrum, Nijmegen, Netherlands
12. Tartu Ulikool Kliinilise meditsiini instituut, Tartu, Estonia
13. Department of Anaesthesia and Reanimation, Hospital Universitario Fundacion Alcorcon, Alcorcón, Spain
14. Department of Public Health, Univerzita Karlova 3 lekarska fakulta, Prague, Czechia
15. Spojena Akreditacni Komise Ceske Republiky, Prague, Czechia
16. HOPE, Brussels, Belgium
17. Nederlands Instituut voor Onderzoek van de Gezondheidszorg, Utrecht, Netherlands
18. Amsterdam Universitair Medische Centra, Amsterdam, Netherlands
19. Optimedis AG, Hamburg, Germany
20. Universitat Witten/Herdecke, Witten, Germany
21. Red de Investigacion en Cronicidad Atencion Primaria y Prevencion y Promocion de la Salud, Barcelona, Spain
22. Fundacion Avedis Donabedian, Barcelona, Spain
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Abstract
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 9717 records identified, 340 studies were included, yielding 1305 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. Conclusions: 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.
Summary
Keywords
Core Measure Set, Core Outcome Set, Outcome Assessment, patient safety, Performance measures
Received
03 October 2025
Accepted
13 February 2026
Copyright
© 2026 Nunes, Teixeira, Leite, Schäfer, Valli, Martínez-Nicolas, Paixão, Seyfulayeva, Abelenda, Rodríguez, Carvalho, Heideveld-Chevalking, Emond, Põlluste, Calsbeek, Arnal-Velasco, Žaludek, Garel, Wagner, Groene, Orrego, Sousa, Scientific Advisory Group, Scientific Executive Group and Consortium. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Ana Beatriz Nunes, ana.nunes@ensp.unl.pt
Disclaimer
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