Background:
At the end of 2006, the Institute of Healthcare Improvement (IHI) leadership announced the 5 Million Lives campaign to foster prevention of adverse events. The IHI global trigger tool (GTT) is the primary measurement tool used to determine degree of campaign success. There is a dearth of data regarding the actual utility of this tool. Lacking this peer‐reviewed information, the IHI 5 Million Lives campaign led us to critically review the GTT and our experience.
Methods:
Standardized sessions utilizing identical training charts for the IHI GTT were used in all 3 locations. Two non‐physicians reviewed each patient record for presence of triggers and adverse events and conferred findings. A physician validated their consensus results. Adverse events were categorized by severity and type of event and collected in a central database. The GTT was used to establish a baseline rate of institutional adverse events and to follow the adverse event rate over time for detection of change.
Results:
From January 2005 through December 2006, 1297 charts were reviewed. In the first year (2005) the 3 hospitals averaged 81 adverse events/1000 patient‐days. In the following year (2006) the hospitals averaged 61 adverse events/1000 patient‐days. The improvement between these 2 time frames was 28.39%, even though improvement work was ongoing during all the months and not limited to 2006. The percent of hospitalizations with an adverse event decreased from 28.3% to 23.7%. Most adverse events were associated with temporary harm and did not require and lengthen hospitalization.
Conclusions:
The IHI global trigger tool can be used to detect adverse events and monitor trends in adverse event rates over time.
Author Disclosure:
J. Huddleston, MD, none; J. Naessens, none; C. McGlone, none; R. Resar, none; S. Swensen, none.