Related Experiment Video
Updated: Mar 19, 2026
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
18.0K
Development of an Emergency Department Trigger Tool Using a Systematic Search and Modified Delphi Process
Richard Thomas Griffey1, Ryan M Schneider1, Lee M Adler2
1From the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri.
Journal of Patient Safety
|June 18, 2016
Summary
This study developed 46 consensus-derived triggers to identify adverse events in the emergency department (ED). These triggers aim to enhance patient safety and quality improvement initiatives within ED settings.
Area of Science:
- Emergency Medicine
- Patient Safety
- Quality Improvement
Background:
- Adverse events in emergency departments (EDs) pose significant risks to patient safety.
- Effective identification of these events is crucial for targeted quality improvement.
Purpose of the Study:
- To develop an emergency department (ED) trigger tool for identifying adverse events.
- To establish a foundation for an ED all-cause harm measurement tool.
Main Methods:
- A modified Delphi process involving emergency medicine safety experts.
- Systematic literature review, expert solicitation, web-based surveys, and in-person consensus meetings.
- Selection and refinement of candidate triggers based on validity, utility, and fidelity.
Main Results:
- Identified 114 candidate triggers from literature and expert input.
- Consensus was reached on 46 triggers for detecting adverse events in ED patients.
- High interrater reliability (κ = 0.80) was achieved during the review process.
Conclusions:
- A set of 46 consensus-derived triggers was successfully developed.
- These triggers require pilot field testing to evaluate their performance in detecting all-cause harm.
- The tool serves as a critical step towards a comprehensive ED harm measurement system.
