The Identification of Adverse Events by Applying "Global Trigger Tool" In Indoor Patients of a Tertiary Care Teaching Hospital

Background: Adverse events (AEs) in hospitalized patients are a significant concern for patient safety. Traditional detection methods often underreport such events. This study evaluates the effectiveness of the IHI GTT in identifying AEs across multiple departments in a tertiary care teaching hospital. Methods: A prospective observational study was conducted over 11 months (December 2022–November 2023) across five departments: Medicine, Surgery, Orthopaedics, OBGY, and ICU. Adult inpatients (≥18 years) with hospital stays >24 hours were included. Patient records were reviewed using the IHI GTT, and identified AEs were validated and categorized using the NCC MERP Index. Results: Among 220 patients, 200 (90.9%) had at least one trigger, and 47 AEs were identified in 41 patients (18.6%). Medication-related triggers were most common (61.18%), followed by care-related (25.77%) and surgical triggers (5.09%). The overall AE rate was 21.36 per 100 patients. Most AEs (68%) occurred within the first 10 days of hospitalization. The highest AE rates were observed in the Orthopaedics and Medicine departments. The tool demonstrated high sensitivity (100%) but low specificity (11.17%). Conclusion: The IHI GTT is a sensitive method for detecting AEs in hospitalized patients, particularly medication-related events. Its implementation can enhance patient safety monitoring and support pharmacovigilance efforts. However, refinement is needed to improve specificity and reduce false positives.