Surgery-related adverse events are among the most common adverse events in-hospital. However, no comprehensive, multidisciplinary perioperative guidelines exist at the European level. The aim of this study is to describe the process and results in achieving European multidisciplinary consensus on perioperative patient safety recommendations.

This multimethod study included: (1) a systematic review of guidelines; (2) selection and synthesis of recommendations; and (3) a two-round modified Delphi technique including a 2-day face-to-face consensus conference. We recruited a panel of two expert groups balanced in terms of gender, geographical origin, and professional background, with meaningful participation from patient representatives. Consensus was defined as at least 70% of the panel rating a recommendation 7–9 on a 9-point Likert scale for importance to patient safety and feasibility of implementation.

The systematic review included 267 guidelines, from which 4666 patient safety recommendations were identified and extracted. After four synthesis rounds, 99 recommendations were presented for the Delphi survey, detailing their strength of recommendation, level of evidence, and methodological quality of the cited guidelines. An expert group, composed of 66 multidisciplinary experts from 19 European countries, participated with a response rate of 80.3%. After the two Delphi rounds and the consensus conference, the panel agreed on a final set of 101 recommended perioperative patient safety practices.

A set of 101 comprehensive, evidence-based, patient-centred perioperative patient safety practices was developed through a European consensus process to improve the quality of care in healthcare facilities across Europe and beyond.