PMID- 27221286
OWN - NLM
STAT- MEDLINE
DCOM- 20170614
LR  - 20191210
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 137
IP  - 6
DP  - 2016 Jun
TI  - Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool.
LID - e20154076 [pii]
LID - 10.1542/peds.2015-4076 [doi]
AB  - BACKGROUND AND OBJECTIVE: Efforts to advance patient safety have been hampered by 
      the lack of high quality measures of adverse events (AEs). This study's objective 
      was to develop and test the Global Assessment of Pediatric Patient Safety (GAPPS) 
      trigger tool, which measures hospital-wide rates of AEs and preventable AEs. 
      METHODS: Through a literature review and expert panel process, we developed a 
      draft trigger tool. Tool performance was tested in 16 academic and community 
      hospitals across the United States. At each site, a primary reviewer (nurse) 
      reviewed  approximately 240 randomly selected medical records; 10% of records underwent an 
      additional primary review. Suspected AEs were subsequently evaluated by 2 
      secondary reviewers (physicians). Ten percent of records were also reviewed by 
      external expert reviewers. Each trigger's incidence and positivity rates were 
      assessed to refine GAPPS. RESULTS: In total, 3814 medical records were reviewed. 
      Primary reviewers agreed 92% of the time on presence or absence of a suspected AE 
      (kappa = 0.69). Secondary reviewers verifying AE presence or absence agreed 92% of 
      the time (kappa = 0.81). Using expert reviews as a standard for comparison, 
      hospital-based primary reviewers had a sensitivity and specificity of 40% and 
      91%, respectively. As primary reviewers gained experience, their agreement with 
      expert reviewers improved significantly. After removing low-yield triggers, 27 
      and 30 (of 54) triggers met inclusion criteria to form final manual and automated 
      trigger lists, respectively. CONCLUSIONS: GAPPS reliably identifies AEs and can 
      be used to guide and monitor quality improvement efforts. Ongoing refinement may 
      facilitate future interhospital comparisons.
CI  - Copyright (c) 2016 by the American Academy of Pediatrics.
FAU - Landrigan, Christopher P
AU  - Landrigan CP
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical 
      School, Boston, Massachusetts; Division of Sleep Medicine, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, 
      Massachussets; clandrigan@partners.org.
FAU - Stockwell, David
AU  - Stockwell D
AD  - Division of Critical Care Medicine, Children's National Medical Center, 
      Washington, District of Columbia; Division of Critical Care Medicine, Department 
      of Pediatrics, School of Medicine, George Washington University, Washington, 
      District of Columbia;
FAU - Toomey, Sara L
AU  - Toomey SL
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical 
      School, Boston, Massachusetts;
FAU - Loren, Samuel
AU  - Loren S
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Tracy, Michaela
AU  - Tracy M
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Jang, Jisun
AU  - Jang J
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Quinn, Jessica A
AU  - Quinn JA
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Ashrafzadeh, Sepideh
AU  - Ashrafzadeh S
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Wang, Michelle
AU  - Wang M
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts;
FAU - Sharek, Paul J
AU  - Sharek PJ
AD  - Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford 
      University School of Medicine; and.
FAU - Parry, Gareth
AU  - Parry G
AD  - Institute for Healthcare Improvement, Cambridge, MA.
FAU - Schuster, Mark A
AU  - Schuster MA
AD  - Division of General Pediatrics, Department of Medicine, Boston Children's 
      Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical 
      School, Boston, Massachusetts;
LA  - eng
GR  - U18 HS020513/HS/AHRQ HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Medical Errors/prevention & control
MH  - Medical Records
MH  - Patient Safety/*standards
MH  - Pediatrics/*standards
MH  - Safety Management/*methods
MH  - United States
EDAT- 2016/05/26 06:00
MHDA- 2017/06/15 06:00
CRDT- 2016/05/26 06:00
PHST- 2016/03/24 00:00 [accepted]
PHST- 2016/05/26 06:00 [entrez]
PHST- 2016/05/26 06:00 [pubmed]
PHST- 2017/06/15 06:00 [medline]
AID - peds.2015-4076 [pii]
AID - 10.1542/peds.2015-4076 [doi]
PST - ppublish
SO  - Pediatrics. 2016 Jun;137(6):e20154076. doi: 10.1542/peds.2015-4076.