'Trigger tool' identifies harm caused to hospitalized patients

A new trigger tool can help identify adverse events in pediatric inpatients, according to a new study published in Pediatrics.

Efforts to advance patient safety have been hampered by a lack of high quality measures of adverse events, which is particularly problematic in pediatrics. However, hospitals mainly identify adverse events by relying on passive voluntary reporting systems, which detect only a small percentage of adverse events.

In a study funded by the Agency for Healthcare Research and Quality (AHRQ), the researchers, from Boston Children's Hospital, created an active surveillance trigger tool to look for signals that suggest adverse events in medical records as a way to quickly and reliably identify adverse events, according to an announcement.

The tool, called the Global Assessment of Pediatric Patient Safety (GAPPS), was built on previous efforts focused on trigger tools for adult patients. The researchers developed the trigger tool through literature review and the use of an expert panel. They conducted a detailed trigger by trigger analysis and field tested the tool on 3,814 medical records from 16 hospitals across the country to retrospectively identify adverse events in pediatric patients. Trigger tools included abrupt medication stops, patient falls, positive C. Difficile test, or return to surgery.

The tool "reliably" detected adverse events among hospitalized children; reviewers agreed with the tool 92 percent of the time at both the primary and secondary review stage.

"With tool automation and further training, we anticipate that the feasibility, reliability and validity of GAPSS will further improve, opening the door to its use as a means of tracking and comparing safety and safety initiatives across institutions," the researchers concluded.

To learn more:
- read the announcement
- here's the abstract