Table 1.

Triggers Included in the Institute for Healthcare Improvement Global Trigger Tool

Care module triggers		Medication module triggers
C1	Transfusion or use of blood products	M1	Clostridium difficile positive culture
C2	Any code or arrest	M2	Partial thromboplastin time >100 seconds
C3	Dialysis	M3	International Normalized Ratio (INR) >6
C4	Positive blood culture	M4	Glucose <50 mg/dL
C5	X-ray or Doppler studies for emboli	M5	Rising BUN or serum creatinine >2 times baseline
C6	Abrupt drop of >25% in hemoglobin or hematocrit	M6	Vitamin K administration
C7	Patient fall	M7	Benadryl (Diphenhydramine) use
C8	Pressure ulcers	M8	Romazicon (Flumazenil) use
C9	Readmission within 30 days	M9	Narcan (Naloxone) use
C10	Restraint use	M10	Antiemetic use
C11	Health care–associated infection of any kind	M11	Oversedation/hypotension
C12	In-hospital stroke	M12	Abrupt medication stop
C13	Transfer to higher level of care	M13	Other
C14	Any procedure complication	Intensive care module triggers
C15	Other	I1	Pneumonia onset
Surgical module triggers		I2	Readmission to intensive care
S1	Return to surgery	I3	In-unit procedure
S2	Change in procedure	I4	Intubation/reintubation
S3	Admission to intensive care postop	Perinatal module triggers
S4	Intubation/reintubation/BiPap in Post-Anesthesia Care Unit (PACU)	P1	Apgar score <7 at 5 minutes
S5	X-ray intraop or in PACU	P2	Maternal/neonatal transport/transfer
S6	Intraop or postop death	P3	Magnesium sulfate or terbutaline use
S7	Mechanical ventilation >24 hours postop	P4	Third- or fourth-degree laceration
S8	Intraop epinephrine, or norepinephrine	P5	Induction of delivery
S9	Postop troponin level >1.5 ng/mL	Emergency department (ED) module triggers
S10	Change of anesthetic during surgery	E1	Readmission to ED within 48 hours
S11	Consult requested in PACU	E2	Time in ED greater than 6 hours
S12	Pathology report normal or unrelated to diagnosis
S13	Insertion of arterial or central venous line during surgery
S14	Operative time greater than 6 hours
S15	Removal/injury or repair of organ