1. Search:	EMIS searches run by practice administrator to identify patients with triggers. Patients identified were exported to worksheets for review by GPs
2. Review:	GPs were alerted to undertake a case note review of patient notes using trigger tool worksheets. GPs focused on the preceding 3 months of care to establish a management narrative and identify any areas where patient safety events may have occurred, or may be at risk of occurring
3. Action:	To remedy any identified patient safety event, for example, medication monitoring, informing patients about diagnoses, repeating blood tests, and making referrals to other services
4. Reflect:	Record free-text reflections on clinical care delivered and any patient safety problems identified. This reflection and the anonymised contents of the worksheet could be exported to use for clinical appraisal