Measuring Organizational Improvement in Safety: Application of the Global Trigger Tool

1Mayo Clinic, Rochester, MN
2Mayo Clinic, Rochester, MN
3Mayo Clinic, Rochester, MN
4Mayo Clinic, Rochester, MN
5Mayo Clinic, Rochester, MN

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 30

Background:

At the end of 2006, the Institute of Healthcare Improvement (IHI) leadership announced the 5 Million Lives campaign to foster prevention of adverse events. The IHI global trigger tool (GTT) is the primary measurement tool used to determine degree of campaign success. There is a dearth of data regarding the actual utility of this tool. Lacking this peer‐reviewed information, the IHI 5 Million Lives campaign led us to critically review the GTT and our experience.

Methods:

Standardized sessions utilizing identical training charts for the IHI GTT were used in all 3 locations. Two non‐physicians reviewed each patient record for presence of triggers and adverse events and conferred findings. A physician validated their consensus results. Adverse events were categorized by severity and type of event and collected in a central database. The GTT was used to establish a baseline rate of institutional adverse events and to follow the adverse event rate over time for detection of change.

Results:

From January 2005 through December 2006, 1297 charts were reviewed. In the first year (2005) the 3 hospitals averaged 81 adverse events/1000 patient‐days. In the following year (2006) the hospitals averaged 61 adverse events/1000 patient‐days. The improvement between these 2 time frames was 28.39%, even though improvement work was ongoing during all the months and not limited to 2006. The percent of hospitalizations with an adverse event decreased from 28.3% to 23.7%. Most adverse events were associated with temporary harm and did not require and lengthen hospitalization.

Conclusions:

The IHI global trigger tool can be used to detect adverse events and monitor trends in adverse event rates over time.

Author Disclosure:

J. Huddleston, MD, none; J. Naessens, none; C. McGlone, none; R. Resar, none; S. Swensen, none.

To cite this abstract:

Huddleston J, Naessens J, McGlone C, Resar R, Swensen S. Measuring Organizational Improvement in Safety: Application of the Global Trigger Tool. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 30. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/measuring-organizational-improvement-in-safety-application-of-the-global-trigger-tool/. Accessed September 17, 2019.

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