The use of "triggers," or clues, to identify adverse events (AEs) is an effective method for measuring the overall level of harm in a health care organization. The IHI Global Trigger Tool for Measuring Adverse Events provides instructions for training reviewers in this methodology and conducting a retrospective review of patient records using triggers to identify possible AEs.

The IHI Global Trigger Tool is best utilized when used by personnel who have been trained as reviewers for this methodology. Below is a suggested plan and materials to help train reviewers on the IHI Global Trigger Tool methodology.

As part of IHI's 5 Million Lives Campaign, a series of calls featuring IHI faculty members offers a basic introduction to using the IHI Global Trigger Tool method for identifying adverse events (harm) and measuring the rate of adverse events over time. These audio recordings and accompanying materials, along with other resources on IHI's website, are referenced here in the suggested training plan.

Suggested Reviewer Training Plan:

1. Read the IHI Global Trigger Tool for Measuring Adverse Events. (about 30 minutes)
   
   [NOTE: Do NOT read the results of training charts (pp. 36-39) when reading the white paper to obtain maximum benefit of training.]
   
   
2. Listen to the IHI Global Trigger Tool Overview audio recording. (90 minutes)

    IHI Global Trigger Tool Overview audio recording
   
   Materials from the audio recording
   

   
   
3. Reviewers should independently review the 5 examples in the Training Record Set using the IHI Global Trigger Tool. Each reviewer should write down findings and then compare with the results of the training charts described in the IHI Global Trigger Tool (pp. 36-39). (about 60 minutes)
   
   
4. Optional: Additional audio recordings feature questions and answers on Trigger Tool use. (60 minutes per recording) 

    IHI Global Trigger Tool Q&A (Part 1) audio recording
   
    IHI Global Trigger Tool Q&A (Part 2) audio recording

In addition to the suggested training plan materials above, other resources may be useful for training reviewers:

• An Introduction to Trigger Tools for Identifying Adverse Events
• IHI Global Trigger Tool Implementation Toolkit