Assessing Perioperative Patient Safety Practices: A Comparative Study of Portuguese Hospitals

Backround

Patient safety is a cornerstone of high-quality perioperative care, yet adherence to best practices remains inconsistent across settings. Systematic assessments are essential to identify gaps, support benchmarking, and inform targeted improvement strategies. This study aimed to assess adherence to evidence-based standardised patient safety practice (SPSP) across the perioperative continuum in three Portuguese tertiary hospitals.

Methods

Multidisciplinary teams in three tertiary hospitals, supported by the national SAFEST coordinator, assessed compliance with 154 measurable elements derived from 104 standardised practices across 12 domains (e.g. medication safety, infection prevention, communication). Data were collected via a structured online platform using a 3-point scale (0=not implemented, 5=partially, 10=fully implemented). Evidence sources included document review, medical records, direct observation, and patient interviews. Descriptive statistics (means, frequencies, standard deviations) were used to summarise compliance levels.

Results

Compliance variability was observed across hospitals and areas. Equipment emerged as the highest-scoring area, achieving an average score (AS) of 9.52/10.0; followed by Communication (AS 8.75/10.0) and Intraoperative Complication Prevention (AS 8.70/10.0). The lowest-scoring areas were continuity of care (AS 7.22/10.0), blood management (AS 7.33/10.0), and human resources (AS 7.50/10.0).

Conlcusions

By highlighting critical areas for improvement - Continuity of Care, Blood Management, and Human Resources - across three Portuguese hospitals, this study offers actionable evidence for hospital administrators and clinical teams to prioritise targeted, institutional-level interventions to improve perioperative patient safety. Such structured assessments are relevant for strengthening quality improvement in European health systems.

Key messages

• The findings highlight blood management, human resources, equipment, and continuity of care as critical areas for improvement in perioperative patient safety within three Portuguese Hospitals.

• The SAFEST self-evaluation tool provides a standardised, evidence-based roadmap for identifying perioperative safety gaps.