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Detection of adverse events in general surgery using the " Trigger Tool" methodology
Ana Isabel Pérez Zapata1, María Gutiérrez Samaniego1, Elías Rodríguez Cuéllar1
1Servicio de Cirugía General, Hospital Universitario 12 de Octubre, Madrid, España.
Cirugia Espanola
|December 3, 2014
Summary
The Global Trigger Tool effectively detects adverse events (AE) in surgical patients, with over half being preventable and directly linked to procedures. This methodology proves highly sensitive and specific for identifying surgical complications.
Area of Science:
- Medical Safety
- Surgical Outcomes
- Healthcare Quality Improvement
Background:
- Surgery presents a high risk for adverse events (AE).
- Existing methods may underestimate AE prevalence in surgical settings.
- Accurate AE detection is crucial for patient safety.
Purpose of the Study:
- To determine the percentage of hospitalization-related AE detected by the Global Trigger Tool (GTT) in surgical patients.
- To characterize these AE, including preventability and relation to surgical procedures.
- To evaluate the validity of the adapted GTT methodology.
Main Methods:
- Retrospective, observational study of general surgery patients undergoing operations.
- Utilized an adapted Global Trigger Tool (GTT) methodology for AE identification via patient record review.
- Assigned harm categories, assessed preventability, and determined relation to surgical procedures.
Main Results:
- Prevalence of AE was 36.8%, with 0.5 AE per patient.
- 56.2% of AE were preventable; 69.3% were directly related to surgery.
- The adapted GTT demonstrated high validity: 86% sensitivity, 93.6% specificity, 89% PPV, 92% NPV.
Conclusions:
- The adapted GTT is highly effective and efficient for detecting AE in surgical patients.
- AE prevalence in surgery is higher than previously estimated by other studies.
- The tool successfully identified all serious AE with minimal false negatives, highlighting its clinical utility.
