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Development and validation of trigger tool for multimorbid patients (MUltimorbid Patients-Estonian Trigger Tool). A
Angela Kannukene1,2, Carola Orrego3,4, Margus Lember1,2
1Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Summary
A new trigger tool effectively identifies adverse events in hospitalized patients with multiple chronic conditions. This validated tool shows promising results for measuring patient safety and may indicate a higher prevalence of adverse events in this population.
Area of Science:
- Healthcare quality improvement
- Patient safety research
- Clinical informatics
Background:
- Healthcare complexity contributes to frequent adverse events.
- Multimorbid patients face elevated risks due to interacting diseases and medications.
- A novel trigger tool was developed and validated for hospitalized multimorbid patients.
Purpose of the Study:
- To develop and validate a novel trigger tool for identifying adverse events in hospitalized multimorbid patients.
- To assess the tool's performance against a reference standard.
Main Methods:
- Mixed-methods approach including literature review, expert panel review, and translation.
- Pilot study for initial validation and refinement of the trigger tool.
- Final validation using the trigger tool against manual chart review on 90 charts.
Main Results:
- The final trigger tool comprises 41 triggers.
- Validation demonstrated sensitivity of 0.61, specificity of 0.85, PPV of 0.79, and NPV of 0.70.
- 38% of charts indicated adverse events, with a higher length of stay for affected patients.
Conclusions:
- A novel, validated trigger tool for adverse event detection in hospitalized multimorbid patients has been developed.
- The tool is recommended for measuring adverse events in this specific patient group.
- Preliminary findings suggest a potentially higher prevalence of adverse events in multimorbid inpatients than previously reported.
