PMID- 32595936
OWN - NLM
STAT- MEDLINE
DCOM- 20201009
LR  - 20210110
IS  - 2046-1402 (Electronic)
IS  - 2046-1402 (Linking)
VI  - 8
DP  - 2019
TI  - Assessing the development and implementation of the Global Trigger Tool method 
      across a large health system in Sicily.
PG  - 263
LID - 10.12688/f1000research.18025.4 [doi]
LID - 263
AB  - Background: The Institute for Healthcare Improvement (IHI) has proposed a new 
      method, the Global Trigger Tool (IHI GTT), to detect and monitor adverse events 
      (AEs) and provide information to implement improvement. In 2015, the Sicilian 
      Health System adopted IHI GTT to assess the number, types and severity levels of 
      AEs. The GTT was implemented in 44 of 73 Sicilian public hospitals and 18,008 
      clinical records (CRs) were examined. Here we present the standardized 
      application of the GTT and the preliminary results of 14,706 reviews of CRs. 
      Methods: IHI GTT was adapted, developed and implemented to the local context. 
      Reviews of CRs were conducted by 199 professionals divided into 71 review teams 
      consisting of three individuals: two of whom had clinical knowledge and 
      expertise, and a physician to authenticate the AE. The reviewers entered data 
      into a dedicated IT-platform. All 44 of the public hospitals were included, with 
      approximately 300,000 yearly inpatient admissions out of a population of 
      approximately 5 million. In total, 14,706 randomized CRs of inpatients from 
      medicine, surgery, obstetric and ICU wards, from June 2015 to June 2018 were 
      reviewed. Results: In 975 (6.6%) CRs at least one AE was found. Approximately 
      20,000 patients of the 300,000 discharged each year in Sicily have at least one 
      AE. In 5,574 (37.9%) CRs at least one trigger was found. A total of 1,542 AEs 
      were found. The analysis of ROC curve shows that the presence of two triggers in 
      a CR indicates with high probability the presence of an AE. The most frequent 
      type of AE was in-hospital related infection. Conclusions: The GTT is an 
      efficient method to identify AEs and to track improvement of care. The analysis 
      and monitoring of some triggers is important to prevent AEs. However, it is a 
      labor-intensive method, particularly if the CRs are paper-based.
CI  - Copyright: (c) 2020 Parrinello V et al.
FAU - Parrinello, Vincenzo
AU  - Parrinello V
AD  - U.O. Qualita e Rischio Clinico, Azienda Ospedaliero-Universitaria 
      "Policlinico-Vittorio Emanuele, Catania, 95129, Italy.
FAU - Grasso, Elena
AU  - Grasso E
AD  - U.O. Qualita e Rischio Clinico, Azienda Ospedaliero-Universitaria 
      "Policlinico-Vittorio Emanuele, Catania, 95129, Italy.
FAU - Saglimbeni, Giuseppe
AU  - Saglimbeni G
AD  - U.O. Qualita e Rischio Clinico, Azienda Ospedaliero-Universitaria 
      "Policlinico-Vittorio Emanuele, Catania, 95129, Italy.
FAU - Patane, Gabriella
AU  - Patane G
AD  - U.O. Qualita e Rischio Clinico, Azienda Ospedaliero-Universitaria 
      "Policlinico-Vittorio Emanuele, Catania, 95129, Italy.
FAU - Scalia, Alma
AU  - Scalia A
AD  - U.O. Qualita e Rischio Clinico, Azienda Ospedaliero-Universitaria 
      "Policlinico-Vittorio Emanuele, Catania, 95129, Italy.
FAU - Murolo, Giuseppe
AU  - Murolo G
AD  - Servizio 8 "Qualita, Governo Clinico e Sicurezza del Paziente", Assessorato della 
      Salute, Regione Siciliana, Palermo, 90145, Italy.
FAU - Lachman, Peter
AU  - Lachman P
AUID- ORCID: 0000-0003-0095-830X
AD  - International Society for Quality in Healthcare, Dublin, D02NY63, Ireland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190307
PL  - England
TA  - F1000Res
JT  - F1000Research
JID - 101594320
SB  - IM
MH  - Cross Infection/epidemiology
MH  - Health Plan Implementation
MH  - Humans
MH  - Patient Admission
MH  - Patient Discharge
MH  - *Patient Safety
MH  - Program Evaluation
MH  - Quality Improvement/*organization & administration
MH  - Sicily
PMC - PMC7308947
OTO - NOTNLM
OT  - Global Trigger Tool
OT  - adverse events detections
OT  - harm
OT  - medical errors
OT  - patient safety
OT  - quality of care
COIS- No competing interests were disclosed.
EDAT- 2019/03/07 00:00
MHDA- 2020/10/10 06:00
PMCR- 2020/07/15
CRDT- 2020/07/29 06:00
PHST- 2020/06/29 00:00 [accepted]
PHST- 2020/07/29 06:00 [entrez]
PHST- 2019/03/07 00:00 [pubmed]
PHST- 2020/10/10 06:00 [medline]
PHST- 2020/07/15 00:00 [pmc-release]
AID - 10.12688/f1000research.18025.4 [doi]
PST - epublish
SO  - F1000Res. 2019 Mar 7;8:263. doi: 10.12688/f1000research.18025.4. eCollection 
      2019.