Description and Evaluation of Adaptations to the Global Trigger Tool to Enhance Value to Adverse Event Reduction Efforts

Kennerly, Donald A.; Saldaña, Margaret; Kudyakov, Rustam; Graca, Briget da; Nicewander, David; Compton, Jan

doi:10.1097/pts.0b013e31827cdc3b

Cited by 39 publications

(64 citation statements)

References 16 publications

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“…34 The GTT consists of 47-55 triggers to identify potential AEs. Reviewing the preventability of adverse events is originally no part of the GTT method, but has been recently included in the studies of Schildmeijer et al, 35 Kennerly et al, 36 Najjar et al 37 and Hwang et al 38 In contrast, the HMPS consists of 16-18 screening criteria (triggers), 27 leading questions for AE detection, of which three questions are crucial for AE determination: injury present; resulting in prolongation of hospital stay, temporary or permanent disability or death and caused by healthcare management. Determination of preventability of AEs is standard within the HMPS method.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

Hanskamp‐Sebregts

Zegers²,

Vincent

et al. 2016

BMJ Open

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ObjectivesRecord review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review.DesignA systematic review of the literature.MethodsWe searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events.ResultsIn 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-rater reliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS.ConclusionsThe reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are potential reference methods that can be used to test concurrent validity.

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Section: Results Of the Literature Searchmentioning

confidence: 99%

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

Hanskamp‐Sebregts

Zegers²,

Vincent

et al. 2016

BMJ Open

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“…Local involvement helps tailor the tool to local conditions, is a powerful driving force for introducing changes to practice and, if involvement is multidisciplinary, then iatrogenic occurrences right along the patient's care pathway can be assessed [39]. In addition, providing feedback to tool designers opens a door to dialogue on risk management.…”

Section: Discussionmentioning

confidence: 99%

Evaluating iatrogenic prescribing: Development of an oncology-focused trigger tool

Hébert¹,

Netzer²,

Ferrua³

et al. 2015

European Journal of Cancer

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“…Landrigan et al 11 reported that internal reviewers rated 63.1% of the AEs found as preventable. Kennerly et al 15 reported that among hospital-acquired AEs, 12.5% were judged to be preventable or probably preventable, and an additional 59% were possibly preventable. In a newly published study, as much as 87% of AEs present on admission to hospital were considered ‘preventable/possibly preventable’ 16…”

Section: Discussionmentioning

confidence: 99%

Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method

et al. 2014

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ObjectivesTo describe the level, preventability and categories of adverse events (AEs) identified by medical record review using the Global Trigger Tool (GTT). To estimate when the AE occurred in the course of the hospital stay and to compare voluntary AE reporting with medical record reviewing.DesignTwo-stage retrospective record review.Setting650-bed university hospital.Participants20 randomly selected medical records were reviewed every month from 2009 to 2012.Primary and secondary outcome measuresAE/1000 patient-days. Proportion of AEs found by GTT found also in the voluntary reporting system. AE categorisation. Description of when during hospital stay AEs occur.ResultsA total of 271 AEs were detected in the 960 medical records reviewed, corresponding to 33.2 AEs/1000 patient-days or 20.5% of the patients. Of the AEs, 6.3% were reported in the voluntary AE reporting system. Hospital-acquired infections were the most common AE category. The AEs occurred and were detected during the hospital stay in 65.5% of cases; the rest occurred or were detected within 30 days before or after the hospital stay. The AE usually occurred early during the hospital stay, and the hospital stay was 5 days longer on average for patients with an AE.ConclusionsRecord reviewing identified AEs to a much larger extent than voluntary AE reporting. Healthcare organisations should consider using a portfolio of tools to gain a comprehensive picture of AEs. Substantial costs could be saved if AEs were prevented.

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Description and Evaluation of Adaptations to the Global Trigger Tool to Enhance Value to Adverse Event Reduction Efforts

Abstract: The GTT can be adapted to health-care organizations' goals and resource limitations. This flexibility was essential in crossing our organization's "value threshold."

Cited by 39 publications

References 16 publications

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

Evaluating iatrogenic prescribing: Development of an oncology-focused trigger tool

Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method

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