Measuring patient harm with Global Trigger Tool
All health trusts measure patient harm using Global Trigger Tool (GTT) in the Norwegian Patient safety campaign
A central objective of the National Patient Safety Campaign In Safe Hands is to reduce patient harm. To find out whether or not we succeed, we need to measure patient harm and observe developments over time.
Global Trigger Tool (GTT) is an internationally recognised and standardised method that helps identify adverse events and areas of improvement by reviewing a small sample of medical records regularly.
The US Institute for Healthcare Improvement (IHI) developed the GTT to quantify adverse events by using a simple and replicable process.
The GTT helps teams rapidly review a small sample of medical records to identify “triggers” that may signal harm from the patient’s point of view.
Why the GTT?
By using the GTT we get an indication of the number of incidences and types of patient harm occurring in Norwegian health and care services.
The GTT is helpful because it gives us the opportunity to monitor the development in the number of patients being harmed over a longer period of time – in every part of the health and care services.
We are hesitant to draw any clear conclusions on the basis of this review, but the GTT is the best method we have in order to find out where we need to intervene, and whether or not we are heading in the right direction.
More research on patient harm will however contribute to elaborate the information drawn from the GTT, and make it more reliable.
GTT results in Norway
Five private hospitals and 18 local health trusts have reviewed medical records by using the GTT in 2011.
A total of 39 GTT teams reviewed the medical records from minimum 200 randomly selected hospital admissions of patients that had been discharged between March 1st and December 31st of 2010. Records of 7819 admissions were reviewed.
• 16 percent of the hospital admissions included at least one adverse event (min 3,5 % - max 38 %).
• 7 percent of the hospital admissions included at least one adverse event that led to prolonged hospitalization (min 2 % - max 18 %).
• 1 percent of the hospital admissions included at least one adverse event that gave the patient permanent harm (min 0 % - max 3 %).
• 0, 66 % of the hospital admissions involved patient harm that led to death (min 0% - max 2 %).
• A total of 8,9 percent of the admissions involved an adverse event that led to prolonged hospitalization or more serious consequences (min 2,5 % - max 21 %).