Patient Safety

HD Follow Up Project

With support from industry partners, the ESA PSQC is currently running a multimethod evaluation and research project to assess the implementation of the Helsinki Declaration on Patient Safety in Anaesthesiology (HD) into clinical practice.

Background – What has led to the start of this Project?


Preventable patient harm is an important challenge in anaesthesiology and perioperative care. As a response, the Helsinki Declaration on Patient Safety in Anaesthesiology (HD) has been launched in 2010 by EBA and ESA.1 Widely recognised as a practical framework for improving patient safety, the HD has been signed by all European National Anaesthesiologists Societies (NAS) and many international societies. Yet, surveys and reports suggest inconsistent or lacking adoption of the HD into clinical practice. Extent and causes of this problem remain unclear.2

What do the Project Partners aim to achieve by this Project?


The purpose of this project is to improve patient safety in line with the HD. Project goals to achieve this purpose are to evaluate adoption of the HD in Europe, to identify variations and barriers in the implementation process, and to develop instruments for better implementation by the use of multi-method approaches. The project is directed and coordinated by the ESA PSQC, supervised by the ESA Board, and advanced by a multidisciplinary project team.


How does the Project work, and what Steps have been taken so far?


Promoting the HD takes a long way from the level of the launching and supporting organisations to the clinical frontline. This way leads across a complex landscape of various healthcare organisation and regulation in different countries, manifold information channels, national and local differences in the organisation and delivery of care, and inconsistent clinical working environments.

Therefore, it is important to use the resources of the project to identify potentially correctable obstacles in this long way, and common weaknesses in perioperative care that can be improved. 

By searching the literature, discussing clinical experiences, and integrating input from implementation science experts, the ESA PSQC has established a roadmap of such obstacles, and of approaches to assess and improve them using multi-method data collections, analyses and integration with previous findings, development of tools for better implementation into practice, and for longterm monitoring of sustainability.

What are the current Activities and the next Steps?


The described roadmap is used as protocol for the comprehensive umbrella project dedicated to assessing and improving implementation of the HD (HD-FU Project). Defined parts of the project will be realised as sub-projects.
A first sub-project has been drafted conjointly by the ESA PSQC and the Lancaster Patient Safety Research Unit (LPSRU), Lancaster, UK. This sub-project has been further elaborated by the LPSRU, and was started in April, 2018.

Regular updates about the current steps, the progress, and the results of the HD-FU Project are communicated using various information channels (see below).

1. Mellin-Olsen J, Staender S, Whitaker DK, Smith AF. The Helsinki Declaration on Patient Safety in Anaesthesiology. Eur J Anaesthesiol. 2010;27(7):592-597.
2. Wacker J. Revisiting the Helsinki Declaration on Patient Safety in Anaesthesiology – A Project to Assess and Improve Implementation into Practice. ESA Newsletter. 2017(69). http://newsletter.esahq.org/revisiting-the-helsinki-declaration-on-patient-safety-in-anaesthesiology-a-project-to-assess-and-improve-implementation-into-practice/.