Global Trigger Tools – Improving Psychiatric Treatment

From the left: Ingvild M. Kvisle from KBT, Arne Okkenhaug (project manager and consultant in Nord-Trøndelag Hospital Trust), and Bodil Landstad (professor at Mittuniversitetet and representative in the project’s reference group).

It’s important that people with user experience take part and influence where they can. This way, we can achieve a better health service for those who need it.

Health services in Norway are required to measure occurrences of adverse events in treatment. This is done through the use of what is called Global Trigger Tools. The method entails searching through journals in order to identify “triggers”, or markers indicating potential causes. Officials in Sweden have adopted the tool for use in the psychiatric sector – but this has yet to be done in Norway. Thus, the psychiatric department at Levanger Hospital has taken the initiative to create a Norwegian handbook for Global Trigger Tools, tailored to Norwegian psychiatry, workers and patients.

User involvement
KBT has provided informants to a focus group in the project. We have given input on what can be defined as adverse events, where to look for them in journals, and what situations may have an increased likelihood for this to occur. This process has also been done with workers in the clinics.
In addition, KBT have provided our own representative in the project’s reference group.

What is a trigger?
The dialogue conference for the project took place in Levanger Hospital February 23. Ingvild M. Kvisle, Geir Småvik and Lasse Barr from KBT attended the conference to discuss what should be included in the Norwegian handbook.
Exceeding a certain limit of psychotropic and antipsychotic medication is considered a trigger in the Swedish manual, and we argued that this limit should be lowered for the Norwegian version. We also argued that unscheduled contact with the emergency rooms in outpatient treatment should be regarded as a trigger.

The Norwegian handbook for Global Trigger Tools will soon be completed. From there, the next step will be to test out this new tool. Investigation groups from clinics in Levanger, Namsos and Stjørdal will be going through a selection of each other’s journals. The handbook will then be further revised in accordance with the findings from the tests. KBT hopes this will go on to serve as a great tool for improving the treatments of psychiatric patients across the nation.


TEXT AND PHOTO: Ingvild M. Kvisle