Global Trigger Tool: Implementation Basics

The use of Btriggers,( 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 Trig- ger 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 com- munity 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 train- ing, and finally to lessons learned in setting up an ongoing system of harm measurement using the Global Trigger Tool.