title: Application of the IHI Global Trigger Tool in measuring the adverse event rate in a Turkish healthcare setting.
abstract: BACKGROUND
  The goal of this study was to measure an adverse event rate and determine the potential usefulness of the Institute for Healthcare Improvement's Global Trigger Tool (GTT). Besides using the GTT to measure the adverse event rate, a comparison was also made with the internal Voluntary Reporting Notification System (VRNS) to identify and compare the strengths and weaknesses of the two approaches.
  
  
  METHODS
  Retrospective data were collected from reported patient safety incidents covering a one-year period at Duzce University Hospital, Turkey. Using a range of selection criteria, a total of 219 patient records were selected and then reviewed by a trained GTT team, to investigate the positive triggers in the content of the patient records.
  
  
  RESULTS
  It was determined that adverse events per 1000 patient days totalled 80.72. Adverse events per 100 admissions were 29.39, and the rate of admissions with adverse events was 16.67%. The comparison between the GTT and the VRNS showed that the GTT is 19 times more sensitive than the VRNS in the adverse event evaluation process.
  
  
  CONCLUSIONS
  This is the first published study of the rate of adverse events in a Turkish healthcare setting using the GTT. It was found that the GTT was applicable in this setting, yielding more accurate measurement of the adverse event rate. However, the content of the GTT should be adjusted regarding the standards and documentations used in the Turkish healthcare system to be more useful.
authors.affiliation: Duzce University, Faculty of Business, Department of Health Institutions Management, Duzce, Turkey.
authors.forename: Mehmet Nurullah
authors.initials: MN
authors.lastname: Kurutkan
authors.affiliation: Duzce University, The Vocational School of Health Services, Duzce, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Usta
authors.affiliation: Gulhane Military Medical Academy, The Vocational School of Health, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Orhan
authors.affiliation: University College London, Department of Management Science and Innovation, London, UK.
authors.forename: M C Emre
authors.initials: MC
authors.lastname: Simsekler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006739:Hospital Administration; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D061214:Patient Safety; D019984:Quality Indicators, Health Care / Q000145:classification / Q000458:organization & administration*; D012189:Retrospective Studies; D017751:Safety Management / Q000458:organization & administration*; D014421:Turkey; D055815:Young Adult
keywords: IHI Global Trigger Tool; Patient safety; adverse event