Q) How do I register to use the Trigger Tool Portal?

There are two ways of registering to use the Trigger Tool Portal.  The first process is to pick a nominated Trigger Tool Lead for your organisation to register it for use of the Trigger Tool.  This person will then be the Lead and organisation Trigger Tool Administrator until such a time as the NHS Institute is contacted to change these details.


You can view a registration guide for this process by clicking here.


The second way of registering to use the Trigger Tool Portal is where your organisation is already registered, but you as a user are not.  Instructions for how to go through this process are available here.


Any questions regarding registration should be send to safer.care@institute.nhs.uk.



Q) Can I request my organisation's Trigger Tools Portal password?

A) No. This is primarily to guarantee the security of the data within the Trigger Tool.  If you are one of the people within your trust who has been identified as needing to be a Trigger Tool Portal user, then you should ask your organisation's Primary User for the password.


The Primary User is the only person who has this password.  For security reasons there is no 'master list' of passwords at the NHS Institute.  The onus is on the Primary User of each organisation to keep this information safe and distribute only to those that should have access to the Trigger Tool Portal.



Q) What if I don't know who my organisation's Primary User is?

A) Email safer.care@institute.nhs.uk with your name and the name of your organisation. You will be contacted shortly with the name and details of the relevant person.



Q) What if the Primary User has left the organisation or moved to a different department and a new Primary User is required?

A) Email safer.care@institute.nhs.uk to inform us that the previous Primary User has left the department/organisation and also advise us of the contact details for the new designated Primary User.  We will then go through our verification process to register the new Primary User.  This could take up to ten working days.  



Q) If I add data to the Trigger Tool Portal is it safe and protected?

A)The NHS Institute website database is held on a separate server from the web-server, and is protected by firewalls that allow access only to the safer care team. The database allows access only with appropriate credentials and these are restricted to the site and authorised Institute users.  Patient identifiable information is not included in the Trigger Tool forms.



Q) What will the NHS Institute use the data for?

A)The NHS Institute’s only interest in the data will be in the development of the Trigger descriptions, at no point will the data be used to see the extent of harm in any NHS organisation.  The Users have full control over what data is stored in the portal and can delete it at any time.



Q) Can I add my own triggers?

A) If you are using the Trigger Tool Portal in a specialist area you may wish to add your own trigger description.  You can add up to five triggers to each of the four Trigger Tools.  You can also place them in the most suitable category, all the analysis will then be available in the reporting tool.



Q) Can we download the base data that feed the analytical tools so that we might conduct further analysis ourselves?

A)Yes, your data can be exported as a CSV file, which can then be used in any data analysis application (including spreadsheets and statistical packages).



Q) Is this tool just designed for secondary care hospitals?

A)The original Trigger Tool Portal was designed for general hospital care.  The NHS Institute have also developed a Trigger Tool for Paediatrics and Primary Care.  We are currently working to develop Trigger Tools for Mental Health, Community Hospitals and Community Nursing. 



Q) Sometimes one of the lines on the SPC chart is a different colour to that displayed in the help section, why?

A)If your SPC chart shows a line in a colour that is not explained in the help section, it is highly likely that two lines have merged together. The most common time this may happen is where there is a run of points (the data line) which are equal to the lower control line.



Q) Will there be any comparative information available so that we can benchmark our progress against others?

A)The Trigger Tool Portal is not designed as a comparative tool, and is not fit for purpose for benchmarking.  This is partly because of the different ways in which individual users make decisions about adverse events, and partly because of the complex and poorly understood factors which influence a provider’s adverse event rate. 



Q) Please will you advise whether it is possible to enter 2 of the same triggers and 2 hars for one audit form entry, or should a note be made in the comments box to alert to the number of triggers and harms?

A)The tool will not allow collection of data in the way you have asked.  You can only tick the box once to say that a trigger has gone off or an adverse event. Using the comments box is a good idea to reinforce if 'extra' harm has been found.



Q) I would like to know how the upper and lower control limits for the spc's are calculated.

A)The upper and lower limits are calculated as three sigma above the average (Upper control limit) and three sigma below the average (lower control limit).  What this really means - it shows us the amount of expected variation according to the case notes that we reviewed in that time period.  For a fuller explanation of statistical process control, please click here.



Q) How is the rate of harm calculated?

A)Using the Trigger Tool Portal you can calculate your organisation's rate of harm.  For the Paediatric, mental health and Trigger Tool the colculation is the same:


Number of adverse events found in Notes reviewed divided by the number of days the patients in thoses notes stayed in the NHS organisation time 1000.


For the Primary Care Trigger Tool the calculation is slightly different.  The number of cases with one or more adverse events divided by the number of case notes reviewd, to calculate the 'mean annual adverse event rate'.



Q) On production of the site based SPC run charts the UCL and LCL vary between data points.  I don't think that this is correct.

A)The upper and lower limits may alter if the count of the number of case note reviews being completed in the month alters.



Q) I am registered to use the Trigger Tool but only have view rights and would like to upgrade this to author rights.  How do I do this?

A)If you know who your trust's Primary User is, ask them to change this.  They should have the administration rights to change this detail.  If you don't know who this is, email safer.care@institute.nhs.uk and the team will look up who your trust's Primary Use is.



Q) How is the 'per 1000 bed days' axis calculated on Harm Events Graphs?

A) Take all the case note reviews done in a month.  Add up all the days that these patients stayed in hospital, 20 for example.  Add up the number of harm events that the 20 people had. Divide one by another.  Then times the answer by 1000.  This gives your rate of harm per 1000 bed days.


Please note that the Trigger Tool works it out for you weekly, monthly or quarterly and is based on the number of case notes that you have completed in that time period.



Q) I am having technical problems who do I contact?

A)Go to the “Contact us” tab and fill in your details.



Q) I am having problems completing a case note review.

A)Email safer.care@institute.nhs.uk