Document Detail


Development of trigger tools for surveillance of adverse events in ambulatory surgery.
MedLine Citation:
PMID:  20513790     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The trigger tool methodology uses clinical algorithms applied electronically to 'flag' medical records where adverse events (AEs) have most likely occurred. The authors sought to create surgical triggers to detect AEs in the ambulatory care setting.
METHODS: Four consecutive steps were used to develop ambulatory surgery triggers. First, the authors conducted a comprehensive literature review for surgical triggers. Second, a series of multidisciplinary focus groups (physicians, nurses, pharmacists and information technology specialists) provided user input on trigger selection. Third, a clinical advisory panel designed an initial set of 10 triggers. Finally, a three-phase Delphi process (surgical and trigger tool experts) evaluated and rated the suggested triggers.
RESULTS: The authors designed an initial set of 10 surgical triggers including five global triggers (flagging medical records for the suspicion of any AE) and five AE-specific triggers (flagging medical records for the suspicion of specific AEs). Based on the Delphi rating of the trigger's utility for system-level interventions, the final triggers were: (1) emergency room visit(s) within 21 days from surgery; (2) unscheduled readmission within 30 days from surgery; (3) unscheduled procedure (interventional radiological, urological, dental, cardiac or gastroenterological) or reoperation within 30 days from surgery; (4) unplanned initial hospital length of stay more than 24 h; and (5) lower-extremity Doppler ultrasound order entry and ICD code for deep vein thrombosis or pulmonary embolus within 30 days from surgery.
CONCLUSION: The authors therefore propose a systematic methodology to develop trigger tools that takes into consideration previously published work, end-user preferences and expert opinion.
Authors:
Haytham M A Kaafarani; Amy K Rosen; Jonathan R Nebeker; Stephanie Shimada; Hillary J Mull; Peter E Rivard; Lucy Savitz; Amy Helwig; Marlena H Shin; Kamal M F Itani
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2010-05-31
Journal Detail:
Title:  Quality & safety in health care     Volume:  19     ISSN:  1475-3901     ISO Abbreviation:  Qual Saf Health Care     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136980     Medline TA:  Qual Saf Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  H    
Affiliation:
Department of Surgery, VA Boston Healthcare System, West Roxbury, Massachusetts 02132, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The value of 'gentle reminder' on safe medical behaviour.
Next Document:  Usefulness of a national parent experience survey in quality improvement: views of paediatric depart...