The Institute for Healthcare Improvement has embarked on a study to measure hospital adverse event (“harm”) rates using the IHI Global Trigger Tool that will provide a foundation for similar research on a national level. The goals of the study are to: 1) develop and deploy a standardized record review methodology for measuring harm due to medical care in hospitalized patients; and 2) estimate and track the level of harm in North Carolina over time by applying this record review methodology in a representative sample of hospitals in the state.