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An arrow pointing somewhere: Qualitative study of the Helsinki declaration on patient safety and its role in European anaesthesiology.

The Helsinki Declaration on Patient Safety in Anaesthesiology (hereafter ‘the Declaration’) was launched in 2010 by the European Board of Anaesthesiologists and the European Union of Medical Specialists in close co-operation with the European Society of Anaesthesi1 ology (ESA). The ESA initiated a project designed to assess and improve the adoption of the Declaration’s requirements, as there were few data about its uptake. The first phase, an online survey of ESA members, was recently published. The second phase of this investigation, reported here, aimed to ask national leaders in anaesthesiology in a number of European countries about patient safety and the role played by the Declaration, and its benefits, limitations and barriers in daily practice. We used a semistructured interview guide with open-ended questions. The interview transcripts were analysed by standard qualitative methods, through a broadly ethnographic approach, drawing on the theoretical framework known as ‘Safety II’, which aims to understand why things go right in healthcare safety most of the time, complementing the ‘Safety I’ approach which seeks to learn from error. Between August 2018 and May 2019, we conducted seventeen interviews with senior national leaders in European anaesthesiology, lasting a median [range] of 56 [34 to 100] min.