[Detection of adverse events using IHI Global Trigger Tool during the adoption of a risk management system: A retrospective study over three years at a department for cardiovascular surgery in Vienna].

BACKGROUND: Several studies point in the direction that the Global Trigger Tool for Measuring Adverse Events (GTT) published by the Institute for Healthcare Improvement (IHI) is an appropriate method to detect adverse events with high specificity, sufficient sensitivity and adequate interrater and intrarater reliability. After passing a certain training period, rating teams in healthcare institutions can successfully detect and reliably compare adverse event rates on local and national levels. To date there exist no published relevant data specifically for departments of cardiovascular surgery.

METHODS: In this single-center, retrospective study adverse event rates were detected using GTT for a department of cardiovascular surgery in a Viennese hospital. Having begun to establish a risk management system in the year 2008, 120 case histories were rated by a trained team for the years 2009 and 2012 each (240 in total).

RESULTS: From 2009 to 2012 the detection rate for adverse events improved significantly from 21.1 to 42.8 events per 1,000 patient days. This change was in agreement with an improvement in the detection rate of adverse events per 100 hospital admissions (from 43.7 to 80.0) as well as an improvement in the detection rate of the proportion of patients suffering from adverse events (from 24.4 % to 42.5 %).

CONCLUSION: In the course of the introduction and continuous optimization of a risk management system, the detection rate of adverse events, as measured with GTT, could be brought up to international standards. Thus, the utility of GTT as a possible instrument to help increase patient safety and improve quality could also be established at a department of cardiovascular surgery.