Faculty and resident opinions regarding the role of morbidity and mortality conference

Harbison, Sean P.; Regehr, Glenn

doi:10.1016/s0002-9610(98)00319-5

Cited by 128 publications

(89 citation statements)

References 2 publications

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“…4,20 Indeed, MMCs for care providers are a traditional means of improving local care management through the discussion of adverse events, complications, or medical errors and the conception of alternative approaches to medical decision making. 21,22 However, an interdisciplinary approach may also emphasize how MMCs can be useful in addition to their educational value, with respect to debate of clinical management and alternative treatments. 21 …”

Section: Literature Reviewmentioning

confidence: 99%

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

Ksouri

Balanant

Tadié

et al. 2010

American Journal of Critical Care

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Background Morbidity and mortality conferences are a tool for evaluating care management, but they lack a precise format for practice in intensive care units. Objectives To evaluate the feasibility and usefulness of regular morbidity and mortality conferences specific to intensive care units for improving quality of care and patient safety. Methods For 1 year, a prospective study was conducted in an 18-bed intensive care unit. Events analyzed included deaths in the unit and 4 adverse events (unexpected cardiac arrest, unplanned extubation, reintubation within 24–48 hours after planned extubation, and readmission to the unit within 48 hours after discharge) considered potentially preventable in optimal intensive care practice. During conferences, events were collectively analyzed with the help of an external auditor to determine their severity, causality, and preventability. Results During the study period, 260 deaths and 100 adverse events involving 300 patients were analyzed. The adverse events rate was 16.6 per 1000 patient-days. Adverse events occurred more often between noon and 4 pm (P = .001).The conference consensus was that 6.1% of deaths and 36% of adverse events were preventable. Preventable deaths were associated with iatrogenesis (P = .008), human errors (P < .001), and failure of unit management factors or communication (P = .003). Three major recommendations were made concerning standardization of care or prescription and organizational management, and no similar incidents have recurred. Conclusion In addition to their educational value, regular morbidity and mortality conferences formatted for intensive care units are useful for assessing quality of care and patient safety.

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Section: Literature Reviewmentioning

confidence: 99%

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

Ksouri

Balanant

Tadié

et al. 2010

American Journal of Critical Care

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“…Furthermore, while trainee and faculty perceptions and attitudes toward M&M conferences have been evaluated before the ACGME and IOM recommendations, they have not been evaluated in the context of systems-focused M&M conferences. 18,19 In a prior study, we describe the well-integrated systems-focused M&M conference at the Beth Israel Deaconess Medical Center (BIDMC) residency program. 10 Using it as a model, we established a new multidisciplinary, systems-focused M&M conference at the University of Pittsburgh Medical Center (UPMC), a large academic medical center without a preexisting M&M conference.…”

Section: Introductionmentioning

confidence: 99%

Implementation and Evaluation of a Multidisciplinary Systems-Focused Internal Medicine Morbidity and Mortality Conference

Gonzalo¹,

Bump²,

Huang³

et al. 2014

Journal of Graduate Medical Education

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Background Morbidity and mortality (M&M) conferences provide a forum for discussing adverse events and systems-based practice (SBP) issues; however, few models for implementing multidisciplinary, systems-focused M&M conferences exist. Objective To implement a new systems-focused M&M conference and evaluate success in focusing on adverse events and systems issues in a nonpunitive, multidisciplinary manner. Methods We implemented a new M&M conference into our large university-based internal medicine residency program. Using content analysis, we qualitatively analyzed audio recordings of M&M conferences from the first year of implementation (2010–2011) to determine the frequency of adverse events (injury resulting from medical care), SBP discussion, and allocation of blame. Multidisciplinary attendance was evaluated by attendance logs. Surveys assessed change in interns' perceptions of M&M conferences before and after the conference series (measured by median Likert-scale response) and trainee/faculty attitudes regarding the goal of M&M conferences. Results There were 226 attendees (66 faculty, 160 residents/fellows) at 9 M&M conferences. Average attendance per conference was 71, with representation from 16 disciplines. All M&M conferences (100%) included adverse events, SBP discussion, and lacked explicit individual blame. Interns' perceptions improved, including their belief that the M&M conference's purpose is systems improvement (4.35 versus 4.71, P = .02) and complications are discussed without blame (3.81 versus 4.34, P = .01). After experiencing M&M conferences, trainees/faculty reported favorable ratings, including beliefs that the M&M conference is important for education (97%) and the purpose is systems improvement (95%). Conclusions The implementation of a new systems-focused M&M conference resulted in a conference series focusing on adverse events and associated system issues in a nonpunitive, multidisciplinary context.

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“…It is unique in providing an open comprehensive review process for consultants and trainees to examine their surgical practice, identify adverse events, critique outcomes and correct errors, all without fear of blame or derision from their peers 1 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite advancing standards in surgical quality and safety, morbidity and mortality data reporting seems to have lagged behind 4 with healthcare providers recognising the need for significant improvement 1 . The integrity of the clinical data has been repeatedly questioned 3 , with regard to the accuracy of its collation and subsequent peer review discussion 5 , therefore outcomes have often been viewed with distrust 6 within the surgical and wider hospital specialities.…”

Section: Introductionmentioning

confidence: 99%

Increasing Reporting of Adverse Events to Improve the Educational Value of the Morbidity and Mortality Conference

McVeigh

Waters

Murphy

et al. 2013

Journal of the American College of Surgeons

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Faculty and resident opinions regarding the role of morbidity and mortality conference

Cited by 128 publications

References 2 publications

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

Implementation and Evaluation of a Multidisciplinary Systems-Focused Internal Medicine Morbidity and Mortality Conference

Increasing Reporting of Adverse Events to Improve the Educational Value of the Morbidity and Mortality Conference

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