Altamonte Springs, Fla.-based Adventist Health System implemented the Institute for Healthcare Improvement Global Trigger Tool for Measuring Adverse Events to more accurately track adverse events, according to a study in The Joint Commission Journal on Quality and Patient Safety.
Adventist Health System began using the GTT in 2009 in 25 of its 42 hospitals using a common electronic medical record. The health system has used the findings from the GTT to develop improvement projects for glycemic management and pressure ulcers.
The authors noted several advantages and disadvantages of using a common EMR to create a centralized GTT process:
Advantages
• Review more patient records annually than is possible using a decentralized process and the same number of personnel.
• Reduce variability in analysts' interpretation of triggers and harms.
• Minimize cost by using a small team to manage the review process system-wide.
• Easily navigate patient charts, as patient information is readily available and uniformly located in all records.
• Analyze patients' records from different facilities within AHS.
• Train new EMR analysts easily.
Disadvantages
• Need to scan handwritten physician progress notes, which are sometimes illegible.
• Physician documentation using a computerized progress-note format and/or voice recognition software can repeat information in the medical record.
• Nurses sometimes document in the EMR by exception, which may make it difficult to determine the cause or effect of patient harm.
• Nurses may document a harm in different sections of the EMR.
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