Improvement in Educational Effectiveness of Morbidity and Mortality Conferences with Structured Presentation and Analysis of Complications

Kim, Michael J.; Fleming, Fergal J.; Peters, Jeffrey H.; Salloum, Rabih M.; Monson, J. R. T.; Eghbali, M

doi:10.1016/j.jsurg.2010.04.005

Cited by 43 publications

(50 citation statements)

References 8 publications

(7 reference statements)

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“…Beginning with surgery followed by anaesthesiology case reviews [2,7,8], M&MCs were more recently extended to other medical subspecialties [9,10,11,12]. In oncology, prevention and management of errors are particularly critical because the patients' health status is poor and the drugs employed are toxic, have a low therapeutic index and are susceptible to be implicated in drug-drug interactions [13,14,15,16,17].…”

Section: Introductionmentioning

confidence: 99%

Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Ranchon¹,

You²,

Salles³

et al. 2013

Chemotherapy

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Background: To reduce the occurrence of medication errors, a systemic approach was developed combining anti-neoplastic medication error reviews and morbidity and mortality conferences (M&MCs). We report the first experience of implementing this strategy in oncology. Methods: The case reports submitted to combined reviews were prepared by physicians and pharmacists, and medication error(s) were described and chronological and root-cause analyses were performed. Results: Ten combined reviews were conducted, which involved the departments of haematology, medical oncology, pneumology, gastroenterology and clinical oncology pharmacy. A total of 91 errors were analysed, of which 3 had reached the patient. Thirty-four corrective actions were proposed; 53% consisted of changes in practice, 35% in procedural reminders and 12% in on-ward education sessions. Conclusions: The combination of medication error reviews and M&MCs appears to be an efficient means of improving cancer patient safety and personnel proficiency. This multidisciplinary work is indispensable to improve future patient management through the critical analysis of past medical errors.

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Section: Introductionmentioning

confidence: 99%

Improving Cancer Patient Care with Combined Medication Error Reviews and Morbidity and Mortality Conferences

Ranchon¹,

You²,

Salles³

et al. 2013

Chemotherapy

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“…Learners also benefit from a well-designed and adaptable program. Many residency programs are improving their curriculum by enhancing didactic sessions such as morbidity and mortality conferences [2] and adding simulation experiences. Portfolios have been assessed and found to be effective for both medical student [3] and resident development [4].…”

Section: Introductionmentioning

confidence: 99%

The reflective statement: A new tool to assess resident learning

Monaghan¹,

Blakely²,

Richardson³

et al. 2012

Journal of Surgical Research

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Purpose Continued assessment and redesign of the curriculum is essential for optimal surgical education. For the last 3 y, we have asked the residents to reflect on the previous week and describe “the best thing” they learned. We hypothesize that this statement could be used to assess the weaknesses or strengths of our curriculum. Methods Starting in 2007, residents filled out surveys approximately 4 times/y at the start of a mandatory conference. They were asked to describe the “best thing” they learned that week, where it was learned, and who taught it. Residents were not asked to classify the item learned by core competency (communication, knowledge, patient care, practice-based learning, professionalism, and systems-based practice). This categorization into core competencies was done as part of our study design. Attending, fellow, resident, or other were used as groups designating who taught each item. Where the item was learned was fit into either clinic, conference, operating room (OR), wards, or self. The impact of postgraduate year (PGY) level on learning was also assessed. χ2 analysis was used to compare groups. Results During the study period, 304 surveys were completed and returned by 65 residents. The majority of responses came from PGY 1 residents (134, 43%). Patient care and knowledge were the most common core competencies learned. As PGY level increased, learning of professionalism (P = 0.035) increased. A majority of learning was experiential (wards and OR, P < 0.0125). Self-learning and learning in clinic was a minor component of learning (P < 0.0125). Learning on wards (P < 0.001) decreased as residents progressed and learning from the OR (P = 0.002) had the opposite trend. Conclusions Patient care and knowledge are the most frequently cited competencies learned by the residents. Self-learning is not a significant source of learning, and the majority of the learning is experiential. It is not known if this was a sign that there was a lack of self-directed learning or that self-directed learning was not an efficient method of learning. In addition, each PGY level learns differently (teacher and location of learning), perhaps reflecting the different needs and/or structure of each PGY. We believe the reflective statement has been and will be a useful tool to assess our curriculum.

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“…Administrative characteristics of effectively run M&M meetings included: A written charter or terms of reference , to clearly define the goals of the meeting A structured meeting format , to assist in keeping discussions focussed on important issues, and to ensure the quality, consistency, and rigour and time limits for case presentations A structured process for case identification , to improve quality and consistency of reporting of complications to the M&M review process, and ensure case mix is diverse for the educational benefit of participants …”

Section: Resultsmentioning

confidence: 99%

“…In total, 19 studies identified enablers, 1,3,6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] and seven identified barriers, 1,3,19,21,[27][28][29] noting that some studies provided information relevant to both. Characteristics of the included studies are reported in Tables 1 and 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Characteristics of the included studies are reported in Tables 1 and 2. The evidence base was heterogeneous in terms of study design and outcomes, and included descriptive studies, [15][16][17] cross-sectional surveys of staff perceptions about an M&M process, 21,28,29 controlled before-and-after studies of new M&M formats 6,13,[18][19][20]25,26 and one RCT. 22 The methodological quality of the included literature reviews was found to be low 14 to medium.…”

Section: Study Characteristicsmentioning

confidence: 99%

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