With support from industry partners, the ESAIC 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. Read the Executive summary here.


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 ESAIC.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 inconsistently or lacking adoption of the HD into clinical practice. Extent and causes of this problem remain unclear.


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 the 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 ESAIC PSQC, supervised by the ESAIC 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 ESAIC 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 a 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.

The first sub-project was drafted conjointly by the ESAIC PSQC and the Lancaster Patient Safety Research Unit (LPSRU), Lancaster, UK. This sub-project has been further elaborated by the LPSRU and started in April 2018.

This research project was officially completed in March 2020. The Final report ‘Evaluation of the extent of implementation of the Helsinki Declaration’, will be published in the European Journal of Anaesthesiology later in 2020. The final report will list recommendations to support further implementation and dissemination of the Helsinki Declaration.

Copy of full report available upon request. Please contact patient.safety@esaic.org for more information.

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. ESAIC Newsletter. 2017(69).
  3. Wu, Henry H.L.; Lewis, Sharon R.; Čikkelová, Mirka; Wacker, Johannes; Smith, Andrew F. Patient safety and the role of the Helsinki Declaration on Patient Safety in Anaesthesiology. A European survey. European Journal of Anaesthesiology: December 2019 – Volume 36 – Issue 12 – p 946–954
  4. APA Newport, Matthew; Smith, Andrew F.; Lewis, Sharon R. An arrow pointing somewhere, European Journal of Anaesthesiology: January 2020 – Volume 37 – Issue 1 – p 1-4



The ESAIC will also take the Helsinki Declaration Follow Up Project (HD-FU) a step further through PRiPSAIC, Peer Review in Patient Safety in Anaesthesiology and Intensive Care. We will now move from investigation to action.

PRiPSAIC will create networks of anaesthesiologists and critical care physicians and give them the tools and support they need to examine their own practice and those of their peers and provide intelligence to design solutions for future safer care.  We will work with industry partners, national societies of anaesthesiology and intensive care to find and network ‘change champions’ and ambassadors for patient safety in hospitals in selected European countries. We will support them to learn from each other as they map and develop their current practice and develop new ways of working for the future.

PRiPSAIC will begin in late 2021.

Evaluation of the extent of implementation of the Helsinki Declaration for Patient Safety in anaesthesiology: a mixed-methods action research project

The goals of the project are to map the extent of, and identify deficiencies and regional differences in, the implementation of the Declaration so far since its launch in 2010, thereby also improving adoption into clinical practice. This will give a snapshot of patient safety in anaesthesiology across Europe and the Declaration’s role within it. Would you like to know more, don’t hesitate to contact us at psqc@esagq.org.



Industry partners

Helsinki Declaration Follow-up project is supported by