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  1. Robert Hurford1,
  2. Sarah Kelly2,
  3. Mark Joyce2,
  4. Mark Kellett1,3,
  5. Christopher Kobylecki3,4
  1. 1Salford Royal NHS Foundation Trust
  2. 2University of Manchester
  3. 3Greater Manchester Neurosciences Centre
  4. 4Institute of Brain, Behaviour and Mental Health, University of Manchester


Background The Institute of Healthcare Improvement Global Trigger Tool (GTT) is designed to identify potential harms (triggers) and adverse events (AEs) in healthcare organisations. There is currently no such tool validated for use in Parkinson's disease (PD) patients. In this two-stage project, we firstly adapted the GTT to target this patient group and secondly piloted it in our centre.

Methods The GTT and PD specific trigger tool (PSTT) were initially applied to a cohort of 45 inpatients with PD to compare their relative sensitivities. The PSTT was subsequently piloted by a trained rater in 50 surgical and medical inpatients in a single centre. The outcome measure was AEs per 100 patients per 1000 days.

Findings The PSTT detected 109 triggers in 30 patients, compared with 52 triggers in 21 patients using the GTT, and detected over twice as many AEs. PD patients on a medical vs surgical ward were more likely to experience AEs (82.3 vs 52.2, p=0.03). Medication errors or delays were a significant contributor to AEs.

Conclusion The PSTT provides a quick and sensitive method for identifying potential and actual harms to inpatients with PD. Implementation of such methods will help improve the quality of patient care.


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