Does Skilled Nursing Facility Trigger Tool used with Global Trigger Tool increase its value for adverse events...

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Geriatric Medicine

Background:

• Adverse events (AEs) are a significant concern in acute geriatric care.
• The Institute for Healthcare Improvement's Global Trigger Tool (GTT) is used for AE detection.
• The Skilled Nursing Facility Trigger Tool (SNFTT) was developed to enhance AE identification.

Purpose of the Study:

• To evaluate the added value of the SNFTT when combined with the GTT for identifying incidents and AEs in an acute geriatric hospital.
• To compare the effectiveness of GTT alone versus GTT plus SNFTT in AE evaluation.

Main Methods:

• A retrospective study analyzed 240 electronic clinical records over one year.
• Records were reviewed using either the GTT alone or the GTT combined with SNFTT.
• Key outcome measures included the number of triggers, identified AEs, AE severity and preventability, GTT incidence rates, and the number needed to alert (NNA).

Main Results:

• 137 AEs were identified in 107 patients (57.1 AEs per 100 admissions).
• Nearly all AEs (92.7%) occurred three or more days post-admission, with 49.6% deemed preventable.
• The NNA for GTT plus SNFTT was 8.6; no significant difference in main outcome measures was observed between the combined tool and GTT alone.
• SNFTT improved the identification of 11 specific trigger categories previously classified as 'Other' within the GTT.

Conclusions:

• Integrating the SNFTT with the GTT did not enhance the overall effectiveness of AE evaluation in this geriatric setting.
• Specific triggers identified by SNFTT have been incorporated into the hospital's general GTT methodology for improved trigger identification.