Valli, ClaudiaSchäfer, Willemijn L.A.Bañeres, JoaquimGroene, OliverArnal-Velasco, DanielLeite, AndreiaSuñol, RosaBallester, MartaGibert Guilera, MarcWagner, CordulaCalsbeek, HiskeEmond, YvetteHeideveld-Chevalking, Anita J.Kristensen, KajaHuibertina Davida van Tuyl, LilianPõlluste, KajaWeynants, CathyGarel, PascalSousa, PauloTalving, PeepMarx, DavidŽaludek, AdamRomero, EvaRodríguez, AnnaOrrego, Carola2025-02-212025-02-212024-06-13PLoS One. 2024 Jun 13;19(6):e0304159. doi: 10.1371/journal.pone.0304159. eCollection 2024http://hdl.handle.net/10400.18/10379Introduction: Adverse events in health care affect 8% to 12% of patients admitted to hospitals in the European Union (EU), with surgical adverse events being the most common types reported. Aim: SAFEST project aims to enhance perioperative care quality and patient safety by establishing and implementing widely supported evidence-based perioperative patient safety practices to reduce surgical adverse events. Methods: We will conduct a mixed-methods hybrid type III implementation study supporting the development and adoption of evidence-based practices through a Quality Improvement Learning Collaborative (QILC) in co-creation with stakeholders. The project will be conducted in 10 hospitals and related healthcare facilities of 5 European countries. We will assess the level of adherence to the standardised practices, as well as surgical complications incidence, patient-reported outcomes, contextual factors influencing the implementation of the patient safety practices, and sustainability. The project will consist of six components: 1) Development of patient safety standardised practices in perioperative care; 2) Guided self-evaluation of the standardised practices; 3) Identification of priorities and actions plans; 4) Implementation of a QILC strategy; 5) Evaluation of the strategy effectiveness; 6) Patient empowerment for patient safety. Sustainability of the project will be ensured by systematic assessment of sustainability factors and business plans. Towards the end of the project, a call for participation will be launched to allow other hospitals to conduct the self-evaluation of the standardized practices. Discussion: The SAFEST project will promote patient safety standardized practices in the continuum of care for adult patients undergoing surgery. This project will result in a broad implementation of evidence-based practices for perioperative care, spanning from the care provided before hospital admission to post-operative recovery at home or outpatient facilities. Different implementation challenges will be faced in the application of the evidence-based practices, which will be mitigated by developing context-specific implementation strategies. Results will be disseminated in peer-reviewed publications and will be available in an online platform.engPatient SafetyPerioperative CareEpidemiologyPrevention and ControlQuality ImprovementStandardsProtocolHumansEuropeSAFESTCuidados de SaúdeMelhoria da qualidadeSegurança cuidados saúdejournal article10.1371/journal.pone.03041591932-620338870215