Using EHR data for monitoring and promoting patient safety: reviewing the evidence on trigger tools

Trigger tools, both paper and automated, have been viewed as a promising technology for patient record content analysis and identification of patient safety adverse events. The requirements and potential barriers for implementation of each line of tools have been explored by means of a literature review focusing on two interconnected subject areas: the Institute of Healthcare Improvement's paper-based Global Trigger Tool, which is currently taken up by several national level patient safety programs, and automated trigger tools, because of their increased feasibility as electronic health record (EHR) adoption grows. This paper provides an overview of the existing evidence on the strengths and weaknesses of each approach, and discusses the implications of the findings from the perspectives of healthcare organizations' management and staff, and from the viewpoint of demands on EHR systems.