The RACA score represents a simple tool and enables comparison between observed and predicted ROSC rates based on readily available variables after CA. Thereby, the RACA score may contribute to preclinical quality assessment and may help analysing the effects of different (post)-resuscitation strategies.

QUIPS shows that outcomes in postoperative pain management can be measured and compared in routine clinical practice. This may lead to improved care. QUIPS reveals which operations are the most painful. Quality improvement initiatives should use as few resources as possible, measure the quality of the outcomes, and provide rapid feedback. Structural and process parameters should be continuously reevaluated to determine their suitability as indicators of quality.

Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.

This is the first study assessing severe incidents and complications from a national outcome-tracking database. Annual identification and review of cases, perhaps with standardized database queries in the respective departments, might provide more detailed information about the cascades that lead to unfortunate outcomes.

We make recommendations for others intending to start new systems and speculate on the prospects for sharing patient safety lessons relevant to anaesthesia at European level.