Some patient safety leaders believe the definition of harm should be broader than the definition in the ihi global trigger tool because health care systems should work to prevent more types of harm than the current definition includes.
The IHI Global Trigger Tool for Measuring Adverse Events provides an easy-to-use method for accurately identifying adverse events (harm) and measuring the rate of adverse events over time. Tracking adverse events over time is a useful way to tell if changes being made are improving the safety of the care processes. The Trigger Tool methodology is a retrospective review of a random sample of inpatient hospital records using “triggers” (or clues) to identify possible adverse events. Many hospitals have used this tool to identify adverse events, to assess the level of harm from each adverse event, and to determine whether adverse events are reduced over time as a result of improvement efforts. It is important to note, however, that the IHI Global Trigger Tool is not meant to identify every single adverse event in an inpatient record. The methodology, recommended time limit for review, and random selection of records are designed to produce a sampling approach that is sufficient to determine harm rates and observe improvement over time.
The Institute for Healthcare Improvement (IHI) formed the Idealized Design of the Medication System (IDMS) Group in May 2000. This group of 30 physicians, pharmacists, nurses, statisticians, and other professionals established an aim to design a medication system that is safer by a factor of 10 and more cost effective than systems currently in use. The Trigger Tool for Measuring Adverse Drug Events was initially developed by this group to assess progress on this safety goal and provided the basis for development of subsequent Trigger Tools.
This white paper is designed to provide comprehensive information on the development and methodology of the IHI Global Trigger Tool, with step-by-step instructions for using the tool to measure adverse events in a hospital.
Learn more about IHI Global Trigger Tool here
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