The challenge of learning from perioperative patient harm

Perioperative patient harm is frequent: Adverse events, more than half of them preventable, occur in about 30% of hospital admissions. Surgical in-hospital mortality in Europe is currently as high as 4% on average. Openly communicating as well as reporting patient harm are key to learning within institutions and improving patient outcomes, but are hindered by strong barriers in the tense working environment of perioperative healthcare. Some interventions to overcome such barriers and to improve patient outcomes are ready for adoption into routine practice. Before implementing safety interventions, specific institutional conditions should be considered to ensure local validity. Sustained improvements require local measurement and long-term monitoring of effects.