Using prospective outcomes data to improve morbidity and mortality conferences

Area of Science:

• Surgical Education
• Quality Improvement in Healthcare
• Patient Outcomes Research

Background:

• Traditional surgical morbidity and mortality (M&M) conferences often focus on rare events and treat complications in isolation.
• This limits their effectiveness in teaching residents to understand and improve patient outcomes.
• An outcomes registry was developed for general surgery to capture prospective data on patient outcomes and adverse events.

Purpose of the Study:

• To integrate prospective data from a general surgery outcomes registry into morbidity and mortality (M&M) conferences.
• To enhance the educational value of M&M conferences for surgical residents and attending physicians.
• To identify opportunities for improving the quality of surgical practice through data-driven review.

Main Methods:

• An outcomes registry prospectively collects data on approximately 2000 general surgery procedures annually.
• Adverse events within 30 days of surgery are categorized by severity (Grades I-IV) by clinical nurse coordinators.
• Data on caseloads and adverse events are provided to senior residents for presentation at M&M conferences, contextualized by departmental and external benchmark data.

Main Results:

• Incorporating outcomes registry data into M&M conferences is feasible and practical.
• This approach allows for the presentation of individual cases within the context of broader departmental experience and trends.
• It facilitates the exploration of relationships between practice changes and patient outcomes.

Conclusions:

• Integrating prospective outcome data into M&M conferences enhances resident and attending physician education.
• This data-driven approach provides significant opportunities for improving surgical quality and patient safety.
• The methodology supports a shift from reviewing isolated complications to understanding recurrent events within care processes.