Peter D Hibbert1,2, Charlotte J Molloy1,2, Tamara D Hooper1,2, Louise K Wiles1,2, William B Runciman1,2,3, Peter Lachman4, Stephen E Muething5, Jeffrey Braithwaite6. 1. Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, New South Wales 2109, Australia. 2. Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia. 3. Australian Patient Safety Foundation, PO Box 2471, IPC CWE-53, Adelaide, South Australia 5001, Australia. 4. Great Ormond Street Hospital NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK. 5. James M. Anderson Center for HealthCare Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. 6. Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, New South Wales 2109, Australia.
Abstract
PURPOSE: This study describes the use of, and modifications and additions made to, the Global Trigger Tool (GTT) since its first release in 2003, and summarizes its findings with respect to counting and characterizing adverse events (AEs). DATA SOURCES: Peer-reviewed literature up to 31st December 2014. STUDY SELECTION: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA EXTRACTION: Two authors extracted and compiled the demographics, methodologies and results of the selected studies. RESULTS OF DATA SYNTHESIS: Of the 48 studies meeting the eligibility criteria, 44 collected data from inpatient medical records and four from general practice records. Studies were undertaken in 16 countries. Over half did not follow the standard GTT protocol regarding the number of reviewers used. 'Acts of omission' were included in one quarter of studies. Incident reporting detected between 2% and 8% of AEs that were detected with the GTT. Rates of AEs varied in general inpatient studies between 7% and 40%. Infections, problems with surgical procedures and medication were the most common incident types. CONCLUSION: The GTT is a flexible tool used in a range of settings with varied applications. Substantial differences in AE rates were evident across studies, most likely associated with methodological differences and disparate reviewer interpretations. AE rates should not be compared between institutions or studies. Recommendations include adding 'omission' AEs, using preventability scores for priority setting, and re-framing the GTT's purpose to understand and characterize AEs rather than just counting them.
PURPOSE: This study describes the use of, and modifications and additions made to, the Global Trigger Tool (GTT) since its first release in 2003, and summarizes its findings with respect to counting and characterizing adverse events (AEs). DATA SOURCES: Peer-reviewed literature up to 31st December 2014. STUDY SELECTION: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA EXTRACTION: Two authors extracted and compiled the demographics, methodologies and results of the selected studies. RESULTS OF DATA SYNTHESIS: Of the 48 studies meeting the eligibility criteria, 44 collected data from inpatient medical records and four from general practice records. Studies were undertaken in 16 countries. Over half did not follow the standard GTT protocol regarding the number of reviewers used. 'Acts of omission' were included in one quarter of studies. Incident reporting detected between 2% and 8% of AEs that were detected with the GTT. Rates of AEs varied in general inpatient studies between 7% and 40%. Infections, problems with surgical procedures and medication were the most common incident types. CONCLUSION: The GTT is a flexible tool used in a range of settings with varied applications. Substantial differences in AE rates were evident across studies, most likely associated with methodological differences and disparate reviewer interpretations. AE rates should not be compared between institutions or studies. Recommendations include adding 'omission' AEs, using preventability scores for priority setting, and re-framing the GTT's purpose to understand and characterize AEs rather than just counting them.
Authors: Maria das Dores Graciano Silva; Maria Auxiliadora Parreiras Martins; Luciana de Gouvêa Viana; Luiz Guilherme Passaglia; Renata Rezende de Menezes; João Antonio de Queiroz Oliveira; Jose Luiz Padilha da Silva; Antonio Luiz Pinho Ribeiro Journal: Br J Clin Pharmacol Date: 2018-07-08 Impact factor: 4.335
Authors: Lipika Samal; Srijesa Khasnabish; Cathy Foskett; Katherine Zigmont; Arild Faxvaag; Frank Chang; Marsha Clements; Sarah Collins Rossetti; Anuj K Dalal; Kathleen Leone; Stuart Lipsitz; Anthony Massaro; Ronen Rozenblum; Kumiko O Schnock; Catherine Yoon; David W Bates; Patricia C Dykes Journal: J Patient Saf Date: 2022-07-21 Impact factor: 2.243
Authors: M F Walji; A Yansane; N B Hebballi; A M Ibarra-Noriega; K K Kookal; S Tungare; K Kent; R McPharlin; V Delattre; E Obadan-Udoh; O Tokede; J White; E Kalenderian Journal: JDR Clin Trans Res Date: 2019-12-10
Authors: Francisco J Molina; Paula T Rivera; Alejandro Cardona; Diana C Restrepo; Oralia Monroy; Daniel Rodas; Juan G Barrientos Journal: World J Crit Care Med Date: 2018-02-04