PMID- 37440353
OWN - NLM
STAT- MEDLINE
DCOM- 20230726
LR  - 20230912
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Print)
IS  - 1353-4505 (Linking)
VI  - 35
IP  - 3
DP  - 2023 Jul 25
TI  - Comparing rates of adverse events detected in incident reporting and the Global 
      Trigger Tool: a systematic review.
LID - 10.1093/intqhc/mzad056 [doi]
LID - mzad056
AB  - Many hospitals continue to use incident reporting systems (IRSs) as their primary 
      patient safety data source. The information IRSs collect on the frequency of harm 
      to patients [adverse events (AEs)] is generally of poor quality, and some 
      incident types (e.g. diagnostic errors) are under-reported. Other methods of 
      collecting patient safety information using medical record review, such as the 
      Global Trigger Tool (GTT), have been developed. The aim of this study was to 
      undertake a systematic review to empirically quantify the gap between the 
      percentage of AEs detected using the GTT to those that are also detected via 
      IRSs. The review was conducted in adherence to the Preferred Reporting Items for 
      Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies published in 
      English, which collected AE data using the GTT and IRSs, were included. In total, 
      14 studies met the inclusion criteria. All studies were undertaken in hospitals 
      and were published between 2006 and 2022. The studies were conducted in six 
      countries, mainly in the USA (nine studies). Studies reviewed 22 589 medical 
      records using the GTT across 107 institutions finding 7166 AEs. The percentage of 
      AEs detected using the GTT that were also detected in corresponding IRSs ranged 
      from 0% to 37.4% with an average of 7.0% (SD 9.1; median 3.9 and IQR 5.2). Twelve 
      of the fourteen studies found <10% of the AEs detected using the GTT were also 
      found in corresponding IRSs. The >10-fold gap between the detection rates of the 
      GTT and IRSs is strong evidence that the rate of AEs collected in IRSs in 
      hospitals should not be used to measure or as a proxy for the level of safety of 
      a hospital. IRSs should be recognized for their strengths which are to detect 
      rare, serious, and new incident types and to enable analysis of contributing and 
      contextual factors to develop preventive and corrective strategies. Health 
      systems should use multiple patient safety data sources to prioritize 
      interventions and promote a cycle of action and improvement based on data rather 
      than merely just collecting and analysing information.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of 
      International Society for Quality in Health Care.
FAU - Hibbert, Peter D
AU  - Hibbert PD
AUID- ORCID: 0000-0001-7865-343X
AD  - Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, 
      Macquarie Park, New South Wales 2109, Australia.
AD  - IIMPACT in Health, Allied Health and Human Performance, University of South 
      Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia.
AD  - South Australian Health and Medical Research Institute, North Terrace, Adelaide, 
      South Australia 5000, Australia.
FAU - Molloy, Charlotte J
AU  - Molloy CJ
AD  - Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, 
      Macquarie Park, New South Wales 2109, Australia.
AD  - IIMPACT in Health, Allied Health and Human Performance, University of South 
      Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia.
AD  - South Australian Health and Medical Research Institute, North Terrace, Adelaide, 
      South Australia 5000, Australia.
FAU - Schultz, Timothy J
AU  - Schultz TJ
AUID- ORCID: 0000-0003-1419-3328
AD  - Flinders Health and Medical Research Institute, Flinders University, Sturt Rd, 
      Bedford Park 5042, South Australia, Australia.
FAU - Carson-Stevens, Andrew
AU  - Carson-Stevens A
AD  - PRIME Centre Wales & Division of Population Medicine, Cardiff University, Heath 
      Park, Cardiff, Wales CF14 4XN, United Kingdom.
FAU - Braithwaite, Jeffrey
AU  - Braithwaite J
AUID- ORCID: 0000-0003-0296-4957
AD  - Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, 
      Macquarie Park, New South Wales 2109, Australia.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
SB  - IM
MH  - Humans
MH  - *Risk Management
MH  - *Patient Safety
MH  - Hospitals
MH  - Medical Records
MH  - Diagnostic Errors
PMC - PMC10367579
OTO - NOTNLM
OT  - adverse events
OT  - healthcare Global Trigger Tool
OT  - hospital incident reporting
OT  - patient safety
OT  - quality of care
OT  - systematic review
EDAT- 2023/07/13 19:15
MHDA- 2023/07/26 06:43
PMCR- 2023/07/13
CRDT- 2023/07/13 12:22
PHST- 2023/01/02 00:00 [received]
PHST- 2023/06/21 00:00 [revised]
PHST- 2023/07/11 00:00 [accepted]
PHST- 2023/07/26 06:43 [medline]
PHST- 2023/07/13 19:15 [pubmed]
PHST- 2023/07/13 12:22 [entrez]
PHST- 2023/07/13 00:00 [pmc-release]
AID - 7223853 [pii]
AID - mzad056 [pii]
AID - 10.1093/intqhc/mzad056 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2023 Jul 25;35(3):mzad056. doi: 10.1093/intqhc/mzad056.