Hospital Care Safer for Children

The Agency for Healthcare Research and Quality (AHRQ) www.ahrq.gov has helped researchers develop a new tool to make care safer for children in hospitals. The “Global Assessment of Pediatric Patient Safety” (GAPPS) trigger tool uses electronic or written data to identify adverse events in pediatric patients.

The GAPPS trigger tool is considered one of the most rigorously developed and widely tested pediatric tool of its kind. To develop the tool, researchers at the Center for Excellence for Pediatric Quality Measurement at Boston Children’s Hospital www.childrenshospital.org built on previous efforts that have largely focused on trigger tools for adult patients.

Researchers convened an expert panel to conduct a detailed trigger-by-trigger analysis. The tool was then field-tested on more than 3,800 medical records from 16 academic and community hospitals across the country and the tool was further refined based on the performance of the triggers.

“This tool will help doctors and other practitioners caring for children develop safer practices,” said AHRQ Director Andy Bindman, M.D., “A reliable trigger tool can help clinicians recognize potential safety concerns quickly from routine information collected from the medical record.”

Trigger tools can improve patient safety by helping staff identify, report, and track events over a period of time as opposed to passive voluntary reporting systems which detect only a small percentage of adverse events. Augmenting voluntary reporting with systematic surveillance may help to improve understanding about safety vulnerabilities.

Christopher P. Landrigan, M.D Associate Professor of Pediatrics and Medicine at Harvard Medical School http://hms.harvard.edu and Research Director of the Inpatient Pediatrics Service at Boston Children’s Hospital, reports, “The GAPPS tool represents a substantial advance over voluntary reporting systems, because it is far more sensitive and consistent.”

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