• Patient safety
• Primary care
• Trigger tools
• General practice

We know for sure that healthcare does good things for a lot of people and that for some, it harms—sometimes concurrently with providing benefits. Quite likely doctors have known this for millennia, inspiring the caution in the Hippocratic oath to ‘first do no harm’. Clinically grounded medical researchers know that medicine is complicated and that things can sometimes go wrong despite the best efforts of conscientious and well-intentioned clinicians. To minimise people's exposure to healthcare that harms them, while maximising their exposure to healthcare that helps, a diverse armamentarium has developed that includes tools such as alarms and alerts built in to equipment, postmarketing medicines surveillance, incident reporting systems, check lists, fish plots, run charts and many other things.

Concern over healthcare safety became increasingly widespread in the closing years of the 20th century but came relatively lately to primary care. Trigger tools are now part of the safety armoury of primary care clinicians.1 ,2 In this context, ‘triggers’ are a somewhat different …