Is a modified Global Trigger Tool method using automatic trigger identification valid when measuring adverse events?

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Clinical Risk Management

Background:

• Adverse events significantly impact patient outcomes and healthcare costs.
• Accurate measurement of adverse events is crucial for effective quality improvement initiatives.
• The Global Trigger Tool (GTT) is a widely used method for identifying adverse events.

Purpose of the Study:

• To evaluate a modified Global Trigger Tool (GTT) method incorporating manual review of automatically triggered records.
• To compare the efficacy and efficiency of the modified GTT with the original GTT method in measuring adverse events.

Main Methods:

• A cross-sectional study compared a modified GTT with manual review against the original GTT.
• 1,233 patient records from a Norwegian hospital trust were analyzed.
• Key performance metrics included recall, precision, specificity, and Cohen's kappa.

Main Results:

• Both methods identified a similar rate of adverse events (35 per 1000 patient days).
• The modified GTT required significantly less manual review time (23 hours vs. 411 hours).
• Recall and precision for the modified GTT were 0.59 and 0.58, respectively.

Conclusions:

• The modified GTT method is a viable and efficient alternative for monitoring adverse event rates.
• Significant time savings with the modified GTT allow for larger sample sizes and enhanced risk mitigation.
• Further development of automatic trigger systems could enable real-time adverse event detection.