Global Trigger Tool: Implementation Basics

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The use of "triggers," or clues, to identify adverse events (AEs) during manual chart review has been found to be a useful method for measuring the overall level of harm in a health care organization. The Institute of Healthcare Improvement Global Trigger Tool for Measuring Adverse Events provides a practical sampling methodology for identifying AEs (harm) and measuring the rate of AEs over time. This paper has been written to assist frontline community hospitals that are contemplating beginning a launch of the Global Trigger Tool methodology.

The experience of a hospital system with 2000-plus beds on 8 campuses (50 to 1000 beds per hospital) with 105,000 annual patient admissions, 327,000 Emergency Department visits, and 1,000,000 patient contacts is described. Florida Hospital is part of the 36-hospital Adventist Health System. This article describes the journey of Florida Hospital from initial leadership agreement, to team training, and finally to lessons learned in setting up an ongoing system of harm measurement using the Global Trigger Tool.

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