The Global Trigger Tool: A review of the evidence

1 Feb 2016 | Adverse Events

The Health Quality & Safety Commission has facilitated a review of literature associated with the development and use of trigger tools to determine rates of harm in health care settings. Trigger tools can function either as a counting system that aims to estimate the rate of harm at an organisation or as an alerting system that aims to highlight the occurrence of a potential adverse event so that it can be mitigated.

This review of evidence focuses on the use of the global trigger tool (GTT) and related versions developed by the Institute of Healthcare Improvement (IHI) in the United States.[1] The review was undertaken using a standard systematic review methodology. It includes a structured search for all published studies that have considered the IHI GTT and its related forms.

The key audience for the review is health professionals looking to use the IHI GTT to complement their other information sources about potential patient harm and to inform quality improvement projects. It is hoped that this is a useful document to assist with the implementation of the GTT methodology in New Zealand health care services.

The review was originally published in 2013 and updated in 2016. Both editions are available below. 


[1] Griffin F, Resar R. 2009. IHI Global Trigger Tool for measuring adverse events. IHI Innovation Series [Internet]. 2nd edition.

Last updated 19/07/2019