Kjersti Mevik1, Tonje E Hansen2, Ellen C Deilkås3, Alexander M Ringdal4, Barthold Vonen5,6. 1. Department of surgery, Nordland Hospital Trust, Bodø, Norway. 2. Nordland Hospital Trust, Bodø, Norway. 3. Unit for Health Service Research, Akershus University Hospital, Lørenskog, Norway. 4. Division of informatics, Nordland Hospital Trust, Post box 1480, Bodø, Norway. 5. Center for Clinical documentation and Evaluation, North Norway Regional Health Trust, Tromsø, Norway. 6. Institute for community medicine, The Artic University of Norway, Tromsø, Norway.
Abstract
OBJECTIVES: To evaluate a modified Global Trigger Tool (GTT) method with manual review of automatic triggered records to measure adverse events. DESIGN: A cross-sectional study was performed using the original GTT method as gold standard compared to a modified GTT method. SETTING: Medium size hospital trust in Northern Norway. PARTICIPANTS: One thousand two hundred thirty-three records selected between March and December 2013. MAIN OUTCOME MEASURE: Records with triggers, adverse events and number of adverse events identified. Recall (sensitivity), precision (positive predictive value), specificity and Cohen's kappa with 95 % confidence interval were calculated. RESULTS: Both methods identified 35 adverse events per 1000 patient days. The modified GTT method with manual review of 658 automatic triggered records identified adverse events (n = 214) in 189 records and the original GTT method identified adverse events (n = 216) in 186 records. One hundred and ten identical records were identified with adverse events by both methods. Recall, precision, specificity and reliability for records identified with adverse events were respectively 0.59, 0.58, 0.92 and 0.51 for the modified GTT method. The total manual review time in the modified GTT method was 23 h while the manual review time using the original GTT method was 411 h. CONCLUSIONS: The modified GTT method is as good as the original GTT method that complies with the GTTs aim monitoring the rate of adverse events. Resources saved by using the modified GTT method enable for increasing the sample size. The automatic trigger identification system may be developed to assess triggers in real-time to mitigate risk of adverse events.
OBJECTIVES: To evaluate a modified Global Trigger Tool (GTT) method with manual review of automatic triggered records to measure adverse events. DESIGN: A cross-sectional study was performed using the original GTT method as gold standard compared to a modified GTT method. SETTING: Medium size hospital trust in Northern Norway. PARTICIPANTS: One thousand two hundred thirty-three records selected between March and December 2013. MAIN OUTCOME MEASURE: Records with triggers, adverse events and number of adverse events identified. Recall (sensitivity), precision (positive predictive value), specificity and Cohen's kappa with 95 % confidence interval were calculated. RESULTS: Both methods identified 35 adverse events per 1000 patient days. The modified GTT method with manual review of 658 automatic triggered records identified adverse events (n = 214) in 189 records and the original GTT method identified adverse events (n = 216) in 186 records. One hundred and ten identical records were identified with adverse events by both methods. Recall, precision, specificity and reliability for records identified with adverse events were respectively 0.59, 0.58, 0.92 and 0.51 for the modified GTT method. The total manual review time in the modified GTT method was 23 h while the manual review time using the original GTT method was 411 h. CONCLUSIONS: The modified GTT method is as good as the original GTT method that complies with the GTTs aim monitoring the rate of adverse events. Resources saved by using the modified GTT method enable for increasing the sample size. The automatic trigger identification system may be developed to assess triggers in real-time to mitigate risk of adverse events.
Authors: Vincenzo Parrinello; Elena Grasso; Giuseppe Saglimbeni; Gabriella Patanè; Alma Scalia; Giuseppe Murolo; Peter Lachman Journal: F1000Res Date: 2019-03-07
Authors: Amina El Saghir; Georgios Dimitriou; Miriam Scholer; Ioanna Istampoulouoglou; Patrick Heinrich; Klaus Baumgartl; René Schwendimann; Stefano Bassetti; Anne Leuppi-Taegtmeyer Journal: Drug Healthc Patient Saf Date: 2021-12-24
Authors: Luisa C Eggenschwiler; Anne W S Rutjes; Sarah N Musy; Dietmar Ausserhofer; Natascha M Nielen; René Schwendimann; Maria Unbeck; Michael Simon Journal: PLoS One Date: 2022-09-01 Impact factor: 3.752