 Good morning. Thank you very much for this very welcome invitation. I am Eduardo de Robertis. I teach anesthesiology and intensive care at the University of Perugia in Italy, and I am the president of the European Society of Anesthesiology and Intensive Care. Well, first of all, I have no conflict of interest regarding this lecture. Well, when I received this invitation and I started to think about the presentation, well, I started to think about what innovation is. Well, if we go, if you go on, if you surf on the Internet, there are several definitions of innovation. I mean, different definitions, but if we go through these definitions, I think that the most frequent words are new and idea. But to, when I also reflect more, I can also consider an innovation, something that has been ignored for a long time, or something that has missed, or also something that has been forgot. So I think that the concept of innovation is quite broad. And so we can consider innovation on new notions or ideas. So we have considered innovation applied in inventions, but also new possibilities and solutions, discovery, unexpected connections. Also, innovation is also sometimes imagination and inspiration, but also creativity. Also, a problem solving can be an innovation also going towards unmet user needs, or also new models of behavior. We have to speak of patient safety. And what means innovation in patient safety? Well, if we go back and think about milestones of patient safety, if we think about this with cheese, well, I think that it was a bright idea, but more than something that can be considered glamorous. Or if we go to the surgical safety checklist, it's really something that has saved many, many lives. But it's something that I cannot consider particularly exciting. So when we face the aspects of patient safety, what we have done over the years is just something that I can see like a composition of a problem. And the analysis of the many aspects that are under the big umbrella of the patient safety. So I want just to jump back of more than 10 years. I mean, we are here, we were here in London in 2009, when we gathered the European Society of Anesthesiology today, European Society of Anesthesiology and the Board of Anesthesia of the UMS. And we started to reason about safety, patient safety, and we started to work for the Helsinki Declaration that was then seen one year after in Helsinki and was seen first by all the European societies, but thereafter as spread worldwide and was well accepted and received by the majority of the countries. More than 10 years have passed. Over the last two years, we have faced the pandemic, and we had a lot of problems. So for some reason, we have somehow slowed down the analysis of what has been done over the last decade. But I mean, we started to study the effects of the Helsinki Declaration. And you see here on this slide how the majority of the issues that were raised by the Helsinki Declaration over the years have been reached. A very, very high percentage of the success in terms of the institutions that have faced and analyzed these aspects. So it was, I would say, a constant meticulous approach, never in spotlights. So nothing glamorous, nothing so expensive, but still extremely important for our patients. And we have also, as a society, with the Helsinki Declaration somehow anticipated what has been then also considered very, very important by the WHO that has launched in 2017 the third global patient safety challenge that is aimed at the reduction of the arm due to medication. So the vision of the European Society of Anesthesia, Anesthesiology and Intense Care is to establish our society as a leader in European patient safety. And we're really to stress the importance of the implementation of the Helsinki Declaration and to promote the highest quality of education and certification. Well, I think that already this vision can be considered innovative. And what we do, we really quietly, I mean, in a constant way, we work for the professional growth, we work for the research, we work for the education of our members and for all the European and worldwide anesthesiologists and intensivists. And it's very, I'm very proud, for instance, that two weeks ago we received the information that a very big research project has been financed by Europe in frame of the arrives on the Europe 2021. And our society is one of the partnership and is involved in the communication and dissemination of the results of this interesting research. So also this means to spread the concept of patient safety. But still as a scientific society, we consider very important the leadership, we consider very important the cultures behind what we want to offer to our members and to our community. Well, we have started to address the problems of the patient safety with what is now called the safety one approach. This means learning from errors with instant reporting. We have worked on standardization to reduce the variability. We have worked on human factors. So we have worked on many, many aspects. But to be honest, these aspects fortunately covered the minority of the numbers of the patients that we treat. Fortunately, the unwanted outcomes are very, very low in numbers. So another aspect that's been raised, why don't we try to learn from what's going well? And so the safety to approach. So what is now doing the European society of anesthesiologist and intense care? Well, patient safety is one of our pillar. And we are now working of the prepsaic is a peer review in patient safety and anesthesiology and intense care. We are working on something already well established that is the safer care to save lives. It's a patient safety training program that is Europe wide. And then we are also working together with the American society with international forum on priority safety and quality. It is a wonderful, it's a wonderful meetings that really brings together the most bright land brains worldwide. So coming back to the prepsaic project, what we want to create is a network of anesthesiologists and intensivists and support them with tools to ensure a good practice for patient safety. And so to provide also what is needed to also to analyze and give solutions for the commitment ahead. We are now starting in four countries, working with international societies. We have identified the hospitals and then we want to go in a cascade approach. And so in a way to cross fertilization the countries in itself and then to expand this project to other countries. I think we have started many years ago the safer care to save lives project. It's an educational program that is, I mean we try to target a multi professional healthcare providers in different settings and so we have several I mean models I would call or I mean several aspects that are covered. Two are very new, we were starting them. So first of all we have an essential patient safety course, then we have also starting now an advanced patient safety course. Then we have already established the online anti-integration simulation master classes that are based on high fidelity. And then the our safety master classes that are for more experienced participants. Well the the safer care to save lives essential patient safety course is our courses that are I mean aimed to improve the patient safety working on human factors to analyze the most common strategies, definitions of nursing declaration, and then we pass to the advanced course that are more I mean we do what we want to form instructors and students and with simulated scenarios with a certification that could be also very certificated after five years with a cascade program in terms of teaching in in countries and then expand in a cascade model this educational program. As you can see we have already a very crowd agenda and what is interesting for us is also another aspect that we are launching this year is the safety month. We are addressing the obstructive aspects for instance in November 2022 and we for for each Tuesday of the month we analyze aspects we start with clinical cases then we analyze guidelines we will meet the experts on the third Tuesday and then we have the webinar so in this way I mean we want to analyze all the aspects of a specific team. Last but not least in June we will meet in Milano for the international forum on perioperative safety and quality this will be a wonderful moment of finally face-to-face meeting so we will have the the possibility to to embrace ourselves however after these months of distance, forced distance and the international forum will be in the same frame of our European Congress, Uranus Tizia that will be in Milano from the 4th to the 6th of June and then also during our focus meeting in Barcelona in October 2022 that is mainly focused on perioperative medicine analyzing the aspects of the myocardium a lot of safety aspects will be also addressed during this focus meeting so our society is really aimed at patient safety and when we speak of innovation I think that is a state of of mind so it's something that it's really in our self and really I don't think that innovation should be referred to something of glamorous or anyhow expensive thank you very much for your kind attention