Development of an Electronic Pediatric All-Cause Harm Measurement Tool Using a Modified Delphi Method

Stockwell, David C.; Bisarya, Hema; Classen, David C.; Kirkendall, Eric S.; Lachman, Peter; Matlow, Anne; Tham, Eric; Hyman, Dan; Lehman, Samuel M.; Searles, Elizabeth; Muething, Stephen E.; Sharek, Paul J.

doi:10.1097/pts.0000000000000139

Cited by 25 publications

(27 citation statements)

References 24 publications

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“…First, as a pilot, our study had a relatively small sample size and only 1 physician reviewer (rather than the more typical design of 2 physician reviewers) to assess and rate the harms. Second, like adult trigger tool studies, 6,19 our study lacked definitive evidence for which triggers were the best to include, and it does not capture all harms. In an effort to construct a parsimonious list of highly predictive triggers, several potential triggers such as hypocalcemia or hypokalemia were not included in the final trigger tool.…”

Section: Discussionmentioning

confidence: 99%

“…19 The PACHMT trigger list ( The reviewer-physician team at each site then applied the standard trigger tool review method to review their 100 charts. There were no limits placed on the review time per chart.…”

Section: Interventionmentioning

confidence: 99%

“…19 Of note, the PACHMT was developed anticipating future automation to allow integration into electronic health records. Using the PACHMT, we sought to pilot test the tool to estimate harm rates across 6 children's hospitals and to ensure the feasibility and appropriateness of the tool as a way to estimate the rates of all-cause harm in hospitalized children.…”

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confidence: 99%

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A Trigger Tool to Detect Harm in Pediatric Inpatient Settings

et al. 2015

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OBJECTIVES: An efficient and reliable process for measuring harm due to medical care is needed to advance pediatric patient safety. Several pediatric studies have assessed the use of trigger tools in varying inpatient environments. Using the Institute for Healthcare Improvement’s adult-focused Global Trigger Tool as a model, we developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments. METHODS: After formal training, 6 academic children’s hospitals used this novel pediatric trigger tool to review 100 randomly selected inpatient records per site from patients discharged during the month of February 2012. RESULTS: From the 600 patient charts evaluated, 240 harmful events (“harms”) were identified, resulting in a rate of 40 harms per 100 patients admitted and 54.9 harms per 1000 patient days across the 6 hospitals. At least 1 harm was identified in 146 patients (24.3% of patients). Of the 240 total events, 108 (45.0%) were assessed to have been potentially or definitely preventable. The most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications. CONCLUSIONS: Consistent with earlier rates of all-cause harm in adult hospitals, harm occurs at high rates in hospitalized children. Availability and use of an all-cause harm identification tool will establish the epidemiology of harm and will provide a consistent approach to assessing the effect of interventions on harms in hospitalized children.

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Section: Discussionmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 99%

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A Trigger Tool to Detect Harm in Pediatric Inpatient Settings

et al. 2015

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“…[8][9][10][11][12][13][14] In addition, we spoke with trigger developers, including those who developed PACHMT and the IHI GTT, to identify any additional triggers and inform GAPPS development. 7 From our review, we compiled a list of 78 candidate triggers for possible inclusion in GAPPS; this list of candidate triggers was compiled by the GAPPS team with input from the developers of PACHMT.…”

Section: Overviewmentioning

confidence: 99%

Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool

et al. 2016

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“…Pediatric trigger tools have been found to be more effective than traditional incident management systems [3••, 4,33,34]. In the UK, the UK Pediatric Trigger Tool (UKPTT) has been developed as a way to measure harm in admitted pediatric patients [35].…”

Section: Care At the System-wide Levelmentioning

confidence: 99%

Building a Culture of Safety in Pediatrics and Child Health

Taitz

2015

Curr Treat Options Peds

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Opinion statementWhile there have been significant technical advances in the provision of health care to children, there remains ongoing challenges in developing a culture of safety in pediatrics and child health. In many health systems, quality and safety programs are fragmented and the results variable. Health leaders need to ensure that care remains compassionate, child centered, and reliable across the systems in which they work. In order to transform our health system, we need to build and spread a culture of safety and reliability. Understanding the challenges and opportunities required to develop a culture of safety in pediatrics is best explored at three different levels. This paper aims to explore opportunities to build a culture of safety in pediatrics and child health at three levels. The first is the ward or unit base, the second is the hospital or heath system at large, and the third is whole system transformation at state, national, and global level.

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Development of an Electronic Pediatric All-Cause Harm Measurement Tool Using a Modified Delphi Method

Cited by 25 publications

References 24 publications

A Trigger Tool to Detect Harm in Pediatric Inpatient Settings

A Trigger Tool to Detect Harm in Pediatric Inpatient Settings

Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool

Building a Culture of Safety in Pediatrics and Child Health

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