IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events

​Institute for Healthcare Improvement
Cambridge, Massachusetts, USA

The IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events provides an easy-to-use method for accurately identifying adverse events (harm) and measuring the rate of adverse event incidence over time in skilled nursing facilities (SNFs). The tool is based on the IHI Global Trigger Tool methodology, a retrospective review of a random sample of inpatient hospital records using “triggers” (or clues) to identify possible adverse events. 

Identifying adverse events and the types of harm resulting from such adverse events can lead to opportunities to improve patient and resident safety. Tracking the rate of adverse events over time is a useful way to tell if changes being made are improving the safety of care processes.

The IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events provides:

  • Step-by-step instructions for using this methodology to identify adverse events in SNFs and determine the level of harm associated with such events
  • Detailed guidance on designing a Trigger Tool review
  • A list of SNF-specific triggers and definitions
  • Examples of adverse events that occur in SNFs
  • An extensive Frequently Asked Questions section 
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