PMID- 22362917
OWN - NLM
STAT- MEDLINE
DCOM- 20120808
LR  - 20220408
IS  - 2044-5423 (Electronic)
IS  - 2044-5415 (Linking)
VI  - 21
IP  - 4
DP  - 2012 Apr
TI  - Assessment of adverse events in medical care: lack of consistency between 
      experienced teams using the global trigger tool.
PG  - 307-14
LID - 10.1136/bmjqs-2011-000279 [doi]
AB  - BACKGROUND: Many patients are harmed as the result of healthcare. A retrospective 
      structured record review is one way to identify adverse events (AEs). One such 
      review approach is the global trigger tool (GTT), a consistent and well-developed 
      method used to detect AEs. The GTT was originally intended to be used for 
      measuring data over time within a single organisation. However, as the method 
      spreads, it is likely that comparisons of GTT safety outcomes between hospitals 
      will occur. OBJECTIVE: To evaluate agreement in judgement of AEs between 
      well-trained GTT teams from different hospitals. METHODS: Five teams from five 
      hospitals of different sizes in the southeast of Sweden conducted a retrospective 
      review of patient records from a random sample of 50 admissions between October 
      2009 and May 2010. Inter-rater reliability between teams was assessed using 
      descriptive and kappa statistics. RESULTS: The five teams identified 42 different AEs 
      altogether. The number of identified AEs differed between the teams, 
      corresponding to a level of AEs ranging from 27.2 to 99.7 per 1000 hospital days. 
      Pair-wise agreement for detection of AEs ranged from 88% to 96%, with weighted kappa 
      values between 0.26 and 0.77. Of the AEs, 29 (69%) were identified by only one 
      team and not by the other four groups. Most AEs resulted in minor and transient 
      harm, the most common being healthcare-associated infections. The level of 
      agreement regarding the potential for prevention showed a large variation between 
      the teams. CONCLUSIONS: The results do not encourage the use of the GTT for 
      making comparisons between hospitals. The use of the GTT to this end would 
      require substantial training to achieve better agreement across reviewer teams.
FAU - Schildmeijer, Kristina
AU  - Schildmeijer K
AD  - Linnaeus University, School of Health and Caring Sciences, Kalmar 39182, Sweden. 
      kristina.schildmeijer@lnu.se
FAU - Nilsson, Lena
AU  - Nilsson L
FAU - Arestedt, Kristofer
AU  - Arestedt K
FAU - Perk, Joep
AU  - Perk J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120223
PL  - England
TA  - BMJ Qual Saf
JT  - BMJ quality & safety
JID - 101546984
CIN - BMJ Qual Saf. 2013 Mar;22(3):271. PMID: 23174663
CIN - BMJ Qual Saf. 2013 Mar;22(3):271-2. PMID: 23424260
MH  - Clinical Competence
MH  - Humans
MH  - Length of Stay
MH  - *Medical Errors
MH  - Medical Records
MH  - Patient Admission
MH  - *Patient Care Team
MH  - *Process Assessment, Health Care
MH  - Quality Indicators, Health Care/statistics & numerical data
MH  - Reproducibility of Results
MH  - Safety Management/*methods
EDAT- 2012/03/01 06:00
MHDA- 2012/08/09 06:00
CRDT- 2012/02/25 06:00
PHST- 2012/02/25 06:00 [entrez]
PHST- 2012/03/01 06:00 [pubmed]
PHST- 2012/08/09 06:00 [medline]
AID - bmjqs-2011-000279 [pii]
AID - 10.1136/bmjqs-2011-000279 [doi]
PST - ppublish
SO  - BMJ Qual Saf. 2012 Apr;21(4):307-14. doi: 10.1136/bmjqs-2011-000279. Epub 2012 
      Feb 23.