VIDApq-Consensus

This is the authors' abstract. We don't add key points for this paper.

Background. Postoperative complications following major non-cardiac surgery affect up to one third of patients and represent a critical patient safety challenge. A substantial proportion of related deaths are preventable — not because the complication itself was unavoidable, but because the clinical system failed to detect it early enough, escalate concern through the right channels, or mobilise an adequate response in time. This phenomenon is known as Failure to Rescue (FTR) and constitutes a direct indicator of institutional quality and safety culture. Knowledge gap. Despite a growing evidence base on individual components of postoperative rescue systems — early warning scores (EWS), continuous wireless vital sign monitoring (CVSMA), rapid response teams (RRT) and patient-initiated escalation — several critical gaps persist. The 2023 SCCM guidelines found insufficient evidence to recommend routine continuous monitoring outside the ICU. Most existing research derives from Anglo-Saxon and Nordic healthcare contexts whose organisational structures, nurse staffing ratios and patient–clinician cultural dynamics differ systematically from those of the Spanish National Health System (SNS). No minimum monitoring sufficiency standard has been established for postoperative patients on general wards. No consensus-based implementation recommendations exist for the SNS. Project aim. The VIDApq-Consensus project will generate the first evidence-based consensus recommendations on postoperative rescue systems adapted to the SNS, through a rigorous two-phase methodology: a Phase I Scoping Review of Reviews (SRoR) to map the existing evidence base and identify knowledge gaps, followed by a Phase II Modified Delphi Study to generate multidisciplinary consensus recommendations across the three components of the 3Rs framework (Recognise, Relay, React). Design. Phase I is a Scoping Review of Reviews (JBI methodology; PRISMA-ScR reporting; OSF pre-registration) in which 14 research sub-questions (RS-1 to RS-14) are addressed through a unified PCC framework targeting reviews as the unit of analysis (systematic reviews, meta-analyses, scoping reviews, umbrella reviews, rapid reviews, integrative reviews, evidence maps and structured narrative reviews). Phase II is a Modified Delphi Study (ACCORD 2024 and CREDES guidelines; pre-registered in OSF; ≥75% OMERACT stratified consensus threshold) with a multidisciplinary panel of 55 recruited panellists including 18 patients and caregivers as full voting members. Timeline. 30 months from May 2026. No activities initiate in August of each project year. Expected completion: November 2028.