Global trigger tools
April 2010
Key points
- There is insufficient evidence about the effectiveness of global trigger tools for the purposes of identifying or monitoring adverse event rates.
- Much of the published evidence uses trigger tools to examine a large sample of patient notes and to draw conclusions about the overall incidence of adverse events.
- Some studies have suggested that the tool may have some validity for making comparisons between organisations or as a broader audit of institutional safety.
- Comparative studies note that global trigger tools may identify different types of adverse events to other assessment methods.
- Whilst some studies suggest that global trigger tools identify a larger number of events, others suggest that global trigger tools may be less effective than other assessment methods.
- The most common recommendation in the literature is to use a range of tools to assess adverse events and track changes rather than relying solely on global trigger tools.
Trigger tools help identify adverse effects and areas for improvement by auditing a small sample of patient notes regularly. This evidence scan signposts published evidence about the benefits and challenges with this approach.
The global trigger tool is being used throughout the UK and is promoted by campaigns sponsored by the Health Foundation such as Patient Safety First.
This evidence scan was undertaken to identify situations in which it is appropriate to use global trigger tools. It is not the task of this document to identify whether such tools are being used appropriately by NHS organisations and teams.
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