[Comparison of the "Trigger" tool with the minimum basic data set for detecting adverse events in general surgery].

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Surgical outcomes analysis

Background:

• Surgery presents a high risk for adverse events (AE).
• Accurate detection of AE is crucial for improving patient safety.
• Existing methods like the MBDS may underestimate AE occurrence.

Purpose of the Study:

• To compare the effectiveness of the Trigger Tool (TT) against the Hospital National Health System's Minimum Basic Data Set (MBDS) in identifying AE.
• To assess AE detection rates in general surgery patients.
• To evaluate the discriminatory power of both detection methods.

Main Methods:

• Retrospective observational study of 2012 general surgery patients.
• AE identification using an adapted Global Trigger Tool (TT) methodology and MBDS data.
• Classification of AE by damage and avoidability.
• ROC curve analysis and Hanley-McNeil test for tool comparison.

Main Results:

• AE prevalence was 36.8%.
• The TT detected 89.9% of AE, significantly higher than MBDS at 28.48%.
• TT demonstrated superior discriminatory power (AUC 0.89 vs. 0.66 for MBDS), with statistically significant differences (P<.001).

Conclusions:

• The Trigger Tool is substantially more effective, detecting three times more adverse events than the MBDS registry.
• The prevalence of AE in general surgery is higher than previously estimated.
• Implementing the TT can lead to more comprehensive patient safety monitoring in surgical settings.