Morbidity and Mortality Conference in Emergency Medicine

Seigel, Todd A.; McGillicuddy, Daniel C.; Barkin, Adam Z.; Rosen, Carlo L.

doi:10.1016/j.jemermed.2008.09.018

Cited by 40 publications

(36 citation statements)

References 14 publications

(13 reference statements)

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“…11,12 Despite this popularity, few studies have examined the characteristics of effective M&M conference 13,14 or proposed a standardized method for case selection or review. 15 In many ways, the catheterization laboratory is an ideal setting for M&M conference.…”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Doll

Overton

Patel

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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Background-Morbidity and mortality conference is a common educational and quality improvement activity performed in cardiac catheterization laboratories, but best practices for case selection and for maximizing the effectiveness of peer review have not been determined. Methods and Results-We reviewed the 10-year percutaneous coronary intervention morbidity and mortality conference experience of an academic medical center. Cases were triggered for review by the occurrence of prespecified procedural events. Summary reports from morbidity and mortality conference discussions were linked to clinical data from the Duke Databank for Cardiovascular Disease to compare baseline and procedural characteristics and to assess postdischarge outcomes. Of 11 786 procedures, from 2004 to 2013, 157 (1.3%) were triggered for review. The most frequent triggering events were cardioversion/defibrillation (72, 0.6%), unplanned use of mechanical circulatory support (64, 0.5%), and major dissection (41, 0.3%). Selected procedures were more likely to include high-risk features, such as ST-segmentelevation myocardial infarction, cardiogenic shock, and multivessel disease, and were associated with higher mortality at 30 days. Only a minority of triggering events were caused by controversial or unacceptable physician behavior. Conclusions-This 10-year experience outlines the processes for conduct of an effective percutaneous coronary intervention morbidity and mortality conference, including a novel approach to case selection and structured peer review leading to actionable quality interventions. The prespecified clinical triggers, captured in the natural workflow by laboratory staff, identified complex cases that were associated with poor patient outcomes. (Circ Cardiovasc Qual Outcomes.

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Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Doll

Overton

Patel

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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“…1,[3][4][5][6][7] By the 1990s, nearly 90% of programs had longitudinal MMCs with varied formats, and most cases did not include morbidity or mortality and rarely discussed unexpected adverse outcomes or processes that contributed to systems-based failures. 2,8,9 Because it provides a forum to discuss adverse events and medical errors, the MMC enables residency programs to address the systems-based practice (SBP) competency as defined by the Accreditation Council for Graduate Medical Education (ACGME) and to fulfill the Institute of Medicine (IOM) recommendations to educate physicians in the examination of systems issues. [10][11][12] Nevertheless, programs have had difficulty teaching and assessing the SBP competency.…”

Section: Introductionmentioning

confidence: 99%

Systems-Based Content in Medical Morbidity and Mortality Conferences: A Decade of Change

Gonzalo¹,

Yang²,

Huang³

2012

Journal of Graduate Medical Education

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Background Following the Accreditation Council for Graduate Medical Education recommendations in 1999 to foster education in the systems-based practice (SBP) competency by examining adverse clinical events, institutions have modified the morbidity and mortality conference (MMC) to increase SBP-related discussion. We sought to examine the extent to which SBP-related content has increased in our department's MMCs compared with MMCs 10 years prior. Method We qualitatively analyzed audio recordings of our MMCs during 2 academic years, 1999–2000 (n = 30) and 2010–2011 (n = 30). We categorized comments and questions from moderators and faculty as SBP or non-SBP and characterized conferences by whether adverse events were presented and which systems issues were discussed. Results Compared with MMCs in 1999–2000, present-day MMCs included a greater average percentage of SBP comments stated (69% versus 12%; P ≤ .001) and questions asked (13% versus 1%; P = .001) by the moderator, SBP comments stated (44% versus 4%; P ≤ .001) and questions asked (19% versus 1%; P ≤ .001) by faculty, and were more likely to present adverse events (87% versus 13%; P < .001). Interrater reliability for the distinction between SBP and non-SBP content was good (κ = 0.647). Most common categories of systems issues discussed in 2010–2011 were critical laboratory value processing and reporting, institutional policies, and hospital-based factors. Conclusions Over the past decade, our MMC has transformed to include more discussion of SBP-related content and adverse events. The MMC can be used to educate residents in SBP and can also serve as a cornerstone for departmental quality and safety initiatives.

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“…We recommend creating an adapted form of an M&MC for emergency medicine and analyzing the entire circuit a patient takes from when he/she enters the care of a mobile emergency unit until the end of his/her stay at a hospital ED [4]. Our survey has shown similarities and also some significant differences between the M&MCs carried out in France and those carried out in other countries [5]. The average frequency of meetings is the same, with a majority of monthly or bimonthly meetings.…”

Section: Discussionmentioning

confidence: 96%

Morbidity and mortality conferences in emergency departments

Vallé

Gasq

Dehours

et al. 2013

European Journal of Emergency Medicine

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In France, emergency departments (EDs) are not yet required to implement Morbidity and Mortality Conferences (M&MCs), but it is likely that they will soon be a requirement. We conducted a national survey through e-mail to evaluate current M&MC practices in EDs in France. Of the 232 questionnaires sent out, 149 responses were analyzed (64%). In total, 73 departments claimed that they carried out M&MCs, 36 (81.1%) at a University hospital (UH) compared with 37 departments (35%) at a non-UH (P < 0.001). In 29% of departments, M&MCs are held once a month (n = 21), in 34% every 2 months, and in 37% of departments they are held at longer intervals. Specialists are invited in 80% of departments (n = 58). All departments carrying out M&MCs finish with corrective action. The frequency with which M&MCs are conducted in EDs in France is low but is increasing. Currently, M&MCs are mainly conducted at UHs; this practice should develop in general hospitals as well.

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Morbidity and Mortality Conference in Emergency Medicine

Cited by 40 publications

References 14 publications

Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Morbidity and Mortality Conference for Percutaneous Coronary Intervention

Systems-Based Content in Medical Morbidity and Mortality Conferences: A Decade of Change

Morbidity and mortality conferences in emergency departments

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