BACKGROUND: The Institute for Healthcare Improvement has tested and taught use of a variety of trigger tools, including those for adverse medication events, neonatal intensive care events, and a global trigger tool for measuring all event categories in a hospital. The trigger tools have evolved as a complimentary adjunct to voluntary reporting. The Trigger Tool technique was used to identify the rate of occurrence of adverse events in the intensive care unit (ICU), and a subset of ICUs described those events in detail. METHODS: Sixty-two ICUs in 54 hospitals (both academic and community) engaged in IHI critical care collaboratives between 2001 and late 2004. Charts were selected using a random sampling technique and reviewed using a two-stage process. RESULTS: The prevalence of adverse events observed on 12,074 ICU admissions was 11.3 adverse events/100 patient days. For a subset of 1,294 charts from 13 ICUs which were reviewed in detail, 1,450 adverse events were identified, for a prevalence of 16.4 events/100 ICU days. Fifty-five percent of the charts in this subset contained at least one adverse event. DISCUSSION: The Trigger Tool methodology is a practical approach to enhance detection of adverse events in ICU patients. Evaluation of these adverse events can be used to direct resource use for improvement work. The measurement of these sampled chart reviews can also be used to follow the impact of the change strategies on the occurrence of adverse events within a local ICU.
BACKGROUND: The Institute for Healthcare Improvement has tested and taught use of a variety of trigger tools, including those for adverse medication events, neonatal intensive care events, and a global trigger tool for measuring all event categories in a hospital. The trigger tools have evolved as a complimentary adjunct to voluntary reporting. The Trigger Tool technique was used to identify the rate of occurrence of adverse events in the intensive care unit (ICU), and a subset of ICUs described those events in detail. METHODS: Sixty-two ICUs in 54 hospitals (both academic and community) engaged in IHI critical care collaboratives between 2001 and late 2004. Charts were selected using a random sampling technique and reviewed using a two-stage process. RESULTS: The prevalence of adverse events observed on 12,074 ICU admissions was 11.3 adverse events/100 patient days. For a subset of 1,294 charts from 13 ICUs which were reviewed in detail, 1,450 adverse events were identified, for a prevalence of 16.4 events/100 ICU days. Fifty-five percent of the charts in this subset contained at least one adverse event. DISCUSSION: The Trigger Tool methodology is a practical approach to enhance detection of adverse events in ICU patients. Evaluation of these adverse events can be used to direct resource use for improvement work. The measurement of these sampled chart reviews can also be used to follow the impact of the change strategies on the occurrence of adverse events within a local ICU.
Authors: Paul J Sharek; Gareth Parry; Donald Goldmann; Kate Bones; Andrew Hackbarth; Roger Resar; Frances A Griffin; Dale Rhoda; Cathy Murphy; Christopher P Landrigan Journal: Health Serv Res Date: 2010-08-16 Impact factor: 3.402
Authors: Peter M Kilbridge; Laura A Noirot; Richard M Reichley; Kathleen M Berchelmann; Cortney Schneider; Kevin M Heard; Miranda Nelson; Thomas C Bailey Journal: J Am Med Inform Assoc Date: 2009-06-30 Impact factor: 4.497
Authors: Allison Lipitz-Snyderman; David Classen; David Pfister; Aileen Killen; Coral L Atoria; Elizabeth Fortier; Andrew S Epstein; Christopher Anderson; Saul N Weingart Journal: J Oncol Pract Date: 2017-01-17 Impact factor: 3.840
Authors: Pascale Carayon; Tosha B Wetterneck; Randi Cartmill; Mary Ann Blosky; Roger Brown; Robert Kim; Sandeep Kukreja; Mark Johnson; Bonnie Paris; Kenneth E Wood; James Walker Journal: BMJ Qual Saf Date: 2013-09-19 Impact factor: 7.035