The Institute for Healthcare Improvement's Global Trigger Tool is a widely used approach for detecting and monitoring safety hazards, but the accuracy of the tool has been criticized. Cases flagged by triggers also require more detailed chart reviews, which may not be feasible for institutions with limited resources. This study reports how one health system attempted to address these limitations of the Global Trigger Tool, with the goal of developing a sustainable mechanism for identifying adverse events (AEs), tracking rates of AEs over time, and providing sufficient detail to inform solutions. The article provides a detailed description of how the tool was adapted and implemented within existing resource constraints, information that may be helpful to other institutions needing to prioritize among multiple potential approaches for improving safety.