Identifying Previously Undetected Harm: Piloting the Institute for Healthcare Improvement's Global Trigger Tool in the Veterans Health Administration
This is a review of the 2015 article "Identifying Previously Undetected Harm: Piloting the Institute for Healthcare Improvement's Global Trigger Tool in the Veterans Health Administration" by Mull et al.[1]
Introduction
Adverse Event (AE)
This study proposes to assess the effectiveness of the Institute for Healthcare Improvement’s Global Trigger Tool (GTT) in a VA facility by examining the overlap of adverse events (AE) detection between GTT and existing surveillance measures.
Methods
Possible Adverse Events: (e.g.: blood or blood product; device or medical-surgical supply, including health information technology; fall; HAI; medication or other substance; pressure ulcer; surgery or anesthesia; and venous thromboembolism)
Results
109 AEs identified using GTT methodology
88% of identified AEs were not detected by the existing surveillance measures such as VA Surgical Quality Program (VASQIP) or Patient Safety Quality Indicators (PSIs) 60% the AEs identified resulted in minor harm
Discussion
Comments
Related Articles
Electronic health record-based triggers to detect potential delays in cancer diagnosis
Electronic health record-based surveillance of diagnostic errors in primary care
References
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/?term=Identifying+Previously+Undetected+Harm%3A+Piloting+the+Institute+for+Healthcare+Improvement%E2%80%99s+Global Mull HJ, Brennan CW, Folkes T, Hermos J, Chan J, Rosen AK, Simon SR.Identifying Previously Undetected Harm: Piloting the Institute for Healthcare Improvement's Global Trigger Tool in the Veterans Health Administration. Qual Manag Health Care. 2015 Jul-Sep;24(3):140-6. doi: 10.1097/QMH.0000000000000060.