Characteristics | Harvard method | Global Trigger Tool |
---|---|---|
Definition of AE | “An unintended injury or complication that results in disability at discharge, death or prolonged hospital stay and is caused by healthcare management rather than the patient’s underlying disease.” | “Unintended injury resulting from or contributed to by medical care that requires additional monitoring, treatment or hospitalization, or that results in death.” |
Focus | Omission and commission | Commission, excludes omission |
Method | Two - three stage retrospective record review | Two stage retrospective record review |
Review Stage 1 | One healthcare professional (most often nurse) | Two independent reviewers per record (e.g. nurse, physician) |
Review Stage 2 | Two independent reviews (most often physicians) | A team discuss the findings together Physician as arbitrator |
Criterion/Trigger | - Comprehensive reading of record - Screening for one of 18 broad criteria | - No comprehensive reading - First screening for one of 54 triggers |
Number of records / Time | Random, large samples | Random, small samples (e.g. 10 records every second week or 20 records every month per hospital) |