PMID- 28598897
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20230928
IS  - 1549-8425 (Electronic)
IS  - 1549-8417 (Linking)
VI  - 17
IP  - 6
DP  - 2021 Sep 1
TI  - Adverse Events Detection Through Global Trigger Tool Methodology: Results From a 
      5-Year Study in an Italian Hospital and Opportunities to Improve Interrater 
      Reliability.
PG  - 451-457
LID - 10.1097/PTS.0000000000000381 [doi]
AB  - OBJECTIVE: Global Trigger Tool (GTT) has been proposed as a low-cost method to 
      detect adverse events (AEs). The validity of the methodology has been questioned 
      because of moderate interrater agreement. Continuous training has been suggested 
      as a means to improve consistency over time. We present the main findings of the 
      implementation of the Italian version of the GTT and evaluate efforts to improve 
      the interrater reliability over time. METHODS: The Italian version of the GTT was 
      developed and implemented at the San Bonifacio Hospital, a 270-bed secondary care 
      acute hospital in Verona, Italy. Ten clinical records randomly selected every 2 
      weeks were reviewed from 2009 to 2014. Two-stage interrater reliability 
      assessment between team members was conducted on 2 subsamples of 50 clinical 
      records before and after the implementation of specific review rules and staff 
      training. RESULTS: Among 1320 medical records reviewed, a total of 366 AEs were 
      found with at least 1 AE on 20.2% of all discharges, 27.7 AEs/100 admissions, and 
      30.6 AEs/1000 patient-days. Adverse events with harm score E and F were 
      respectively 58.2% (n = 213) and 38.8% (n = 142). First round interrater 
      reliability was comparable with other international studies. The interrater 
      agreement improved significantly after intervention (kappa interrater I = 0.52, kappa 
      interrater II = 0.80, P < 0.001). CONCLUSIONS: Despite the improvements in the 
      interrater consistency, overall results did not show any significant trend in AEs 
      over time. Future studies may be directed to apply and adapt the GTT methodology 
      to more specific settings to explore how to improve its sensitivity.
CI  - Copyright (c) 2017 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Mortaro, Alberto
AU  - Mortaro A
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Moretti, Francesca
AU  - Moretti F
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Pascu, Diana
AU  - Pascu D
AD  - Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy.
FAU - Tessari, Lorella
AU  - Tessari L
AD  - Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy.
FAU - Tardivo, Stefano
AU  - Tardivo S
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Pancheri, Serena
AU  - Pancheri S
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Marta, Garon
AU  - Marta G
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Romano, Gabriele
AU  - Romano G
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Mazzi, Mariangela
AU  - Mazzi M
AD  - From the University of Verona, Department of Diagnostic and Public Health.
FAU - Montresor, Paolo
AU  - Montresor P
AD  - Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy.
FAU - Naessens, James M
AU  - Naessens JM
AD  - Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Patient Saf
JT  - Journal of patient safety
JID - 101233393
SB  - IM
MH  - Hospitals
MH  - Humans
MH  - Italy
MH  - *Medical Errors
MH  - *Patient Safety
MH  - Reproducibility of Results
COIS- The authors disclose no conflict of interest.
EDAT- 2017/06/10 06:00
MHDA- 2021/11/25 06:00
CRDT- 2017/06/10 06:00
PHST- 2017/06/10 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2017/06/10 06:00 [entrez]
AID - 01209203-202109000-00008 [pii]
AID - 10.1097/PTS.0000000000000381 [doi]
PST - ppublish
SO  - J Patient Saf. 2021 Sep 1;17(6):451-457. doi: 10.1097/PTS.0000000000000381.