Identifying and measuring patient harms. A study of measuring adverse events in hospitalised patients by the Global Trigger Tool record review method
Year: 2019
Type: dissertation
Abstract: Patient harms, or adverse events which is the term used in this PhD thesis, is a global health problem. The Global Trigger Tool (GTT) is a widely used method to identify and measure adverse events (AEs). The method involves reviewers searching for triggers (situations) in randomly selected medical records and subsequently identifying AEs. However, the method is criticized due to the time used by reviewers, the sampling strategy and low agreement between review teams. The overall aim of this PhD was to evaluate the effect of increasing the number of records to be reviewed, changes of reviewers and the use of automatic versus manual trigger identification in the GTT. This was investigated in order to improve the validity and reliability of the GTT, and to increase the efficiency of the method by reducing the personnel time required to identify AEs. \n\nThe results showed that increasing the sample size seven times increased the precision of the results as the confidence interval is narrower than in a smaller samples size. In a large sample a higher rate of adverse events was identified than in a small sample. Keeping at least one reviewer consistent increased the agreement of the identified AEs. The use of automatic trigger identification identified the same rate of AEs as with the use of manual trigger identification, and was time efficient. These adjustments increase the validity and reliability of the GTT and reduce the review time and resources used.
Author: Kjersti Mevik
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2954630875