Trigger tool versus verbal inventory to detect surgical complications.

Area of Science:

• Medical Informatics
• Surgical Outcomes Research
• Health Services Research

Background:

• Traditional methods for identifying surgical complications rely on voluntary reporting, potentially underestimating their true incidence.
• Incident reports are also used but may not capture all adverse events comprehensively.
• A novel trigger tool was developed to improve the detection of complications in hospitalized surgical patients.

Purpose of the Study:

• To develop and validate a trigger tool for detecting surgical complications.
• To compare the sensitivity and specificity of this trigger tool against a verbal inventory method used by surgical staff and residents.

Main Methods:

• A systematic review identified 31 potential triggers, integrated into a trigger tool using multivariable regression and ROC analyses.
• A reference standard of 300 patients (150 with and 150 without complications) was used for validation.
• Sensitivity and specificity were calculated for both the trigger tool and the verbal inventory.

Main Results:

• The final trigger tool comprised nine triggers.
• The trigger tool demonstrated sensitivities of 70.7% and specificities of 70.0%.
• The verbal inventory had sensitivities of 78.7% and specificities of 100.0%.
• For major complications, the trigger tool's sensitivity was 97.2% compared to 80.6% for the verbal inventory.

Conclusions:

• The customized trigger tool for a university hospital is as accurate as a verbal inventory for detecting surgical complications.
• The trigger tool is more sensitive than the verbal inventory in identifying major complications.
• This tool offers a valuable method for improving surgical complication surveillance.