The Institute for Healthcare Improvement's (IHI) Global Trigger Tool is a well-established sampling method for measuring adverse events in adult patients. Previously, a modified pediatric-focused tool aimed at identifying medication-related errors was developed; however, the full IHI trigger tool has never been formally evaluated in a pediatric setting. In this retrospective chart review study, the Global Trigger Tool identified a higher rate of harm (2 to 3 times) than that seen in previous pediatric research. Dr. Paul Sharek discusses trigger tools and other approaches for measuring adverse event rates in an AHRQ WebM&M perspective.