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Experiences with global trigger tool reviews in five Danish hospitals: an implementation study.
Christian von Plessen1, Anne Marie Kodal, Jacob Anhøj
1Department of Pulmonary Medicine and Infectious diseases, Hilleroed Hospital, Hilleroed, Denmark.
BMJ Open
|October 16, 2012
Summary
Global Trigger Tool (GTT) reviews showed significant variation in patient harm rates across Danish hospitals. Standardizing reviewer training and procedures can improve GTT performance and patient safety monitoring.
Area of Science:
- Patient Safety
- Healthcare Quality Improvement
- Medical Record Review
Background:
- Measuring and monitoring patient harm is essential for improving healthcare safety.
- The Global Trigger Tool (GTT) is increasingly used globally to assess patient harm.
- Understanding GTT performance in diverse healthcare settings is crucial.
Purpose of the Study:
- To document experiences implementing GTT reviews in five Danish hospitals.
- To identify factors influencing GTT performance.
- To propose strategies for enhancing GTT review team effectiveness.
Main Methods:
- Retrospective observational study design.
- Analysis of harm rates and patient safety incidents (PSIs) from five Danish pilot hospitals.
- Harm categorization by experienced reviewers and run-chart analysis for non-random variation.
Main Results:
- Patient safety incidents (PSIs) ranged from 3 to 12 per 1000 patient-days.
- Average harm rates varied significantly, from 34 to 84 per 1000 patient-days.
- Common harms included infections, pressure ulcers, and procedure-related issues; 96% were temporary.
Conclusions:
- Substantial variation in harm rates was observed, likely due to differences in training and review procedures.
- Standardized team training, defined reviewer roles, and improved documentation practices are recommended.
- Implementing a findings database can further enhance GTT application and patient safety initiatives.
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