Pediatric Research in Inpatient Settings Network

Project Summary

We plan to test the refined trigger tool in a national stratified sample of PRIS hospitals to validate its use across different hospital settings.  Each hospital based team will conduct 240 chart reviews of randomly selected charts drawn from 2006-2012, using the trigger tool.  A nurse reviewer will conduct initial reviews, with a sample of charts re-reviewed both by him or herself (intra-rater reliability testing) and by a second hospital based nurse reviewer (inter-rater reliability testing).  All incidents detected at this initial stage will then be reviewed by two physician reviewers at a second stage, to make final determinations about whether an adverse event actually occurred, as well as its severity and preventability.


The objective of this project is to test the validity and reliability of the Global Assessment of Pediatric Patient Safety (GAPPS) tool in identifying adverse events in the inpatient setting. In the pilot phase of the project, the efficacy and accuracy of an existing global pediatric trigger tool was tested as a potential method to quantify adverse events. In the current phase of this project we will nationally test a trigger tool modified based on pilot study and expert panel results to validate its use across different hospital settings. 

This project has two specific aims:

  • To test a pediatric-specific global trigger tool, GAPPS, used to detect adverse events in all areas of care; and
  • To test the GAPPS tool in a national setting allowing for comparison and utilization across a variety of hospitals with differing characteristics to allow improved national application across a large number of care centers.


Agency for Healthcare Research and Quality (AHRQ) 5U018HS020513-03