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Table 1 Brief overview on the characteristics and differences between the ‘Harvard method’ and the ‘Global Trigger Tool method’ to detect AEs through retrospective medical record review based on Unbeck et al. [8]

From: The occurrence, types, consequences and preventability of in-hospital adverse events – a scoping review

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)