Helsinki Declaration implementation after 6 years: evaluation of current status in hospitals in Catalonia

Author(s):	Alarcón A., Moret E., Canet J.
Institute(s):	University Hospital Germans Trias i Pujol, Dept of Anaesthesiology & Intensive Care, Badalona, Spain

Text:	
Background and Goal of Study: The Helsinki Declaration (HD) on Patient safety in Anaesthesiology was signed in June 2010 in Europe in order to improve patient safety in preoperative anaesthesia care. The aim of this study was to assess the current state of accomplishment among hospitals in Catalonia, which cover a population of 7.5 million people. 

Materials and Methods: An on-line survey was sent by email to the heads of departments of all hospitals in Catalonia. The survey analyzed the accomplishment of all recommendations outlined in the HD: presence of recovery room and standard monitoring, protocols in emergency situations, use of sedation guidelines, implementation of surgical checklist, delivery of annual safety reports including measures taken and results obtained in improving patient safety, annual report on patient morbidity and mortality and the use safe practice and critical incident reporting systems. Data are presented as absolute numbers and/or percentages.

Results and Discussion: A total of 29 completed questionnaires were collected out of 40 Anaesthesiology Departments (response rate of 72.5%). Of which 24 public and 5 private institutions. The recorded variables were: 96% of the responding hospitals had a recovery room, 51.7% of them 24 hours/day. 96% of the hospitals used standard monitoring routinely in operating rooms and the recovery room. 79.3% of the hospitals followed all protocols according to the HD. 62.5% of them used recognized sedation guides. 72.4% had a modified surgical checklist version from the WHO. 65.5% of the hospitals carried out an annual safety report, including safety measures in 78.9% of them. Morbidity and mortality annual reports were carried out periodically in 62% of the hospitals surveyed. 88.2% of these had established feedback mechanisms after analysis of critical incidents and 94.1% discussed improvement measures in sessions. 82.3% published the results in annual reports. 75.8% had already implemented critical incident reporting systems and 65.2% published annual reports.

Conclusion(s): Patient safety is an essential component of risk management, clinical management and quality improvement in Anaesthesiology. Our results showed that most of the safety standards recommended in the HD were already applied in Catalan hospitals. Annual reports about morbidity/mortality and reported critical incidents should be improved in Catalan hospitals in the future.