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The morbidity and mortality conference: a prolegomenon on its role as an anesthesia risk-management tool
Abstract:
Although the morbidity and mortality conference (MMC) is an essential component of any anesthesia risk-management program, it has not undergone systematic analysis. All MMC narratives detailing the proceedings at two university centers from June 1988 to June 1990 were examined by content analysis and the unique perspectives of MMC participants were captured. The majority of MMC events were of an educational or informational nature; 32% dealt with patient complications, and 14% involved incidents that could have led to detrimental outcomes. Participant beliefs were ultimately organized into categories describing "the lived experience" of the MMC. These included (1) disclosure of knowledge, (2) correspondence of relationship, (3) teaching conformity to rule, (4) developing a sense of aplomb, (5) preparation for litigation, (6) the ceremony, (7) a quality-assurance mechanism, (8) a personal lambaste function, and (9) an instrument of punitive retribution. The MMC appeared improperly named; "case conference" or "clinical teaching conference" may serve as a more accurate rubric. The MMC played a variety of cognitive and affective roles. Recognition of the nature of the teaching and learning associated with the MMC will allow risk managers to utilize it optimally in achieving envisioned objectives that enhance patient outcomes.
Insights
The morbidity and mortality conference (MMC) is vital for anesthesia risk management but needs better naming. Analysis revealed its diverse educational, quality assurance, and personal roles, impacting patient outcomes.
Area of Science:
- Anesthesiology
- Medical Education
- Patient Safety
Background:
- Morbidity and mortality conferences (MMCs) are crucial for anesthesia risk management.
- Systematic analysis of MMCs and participant perspectives has been lacking.
- Understanding the MMC's function is key to optimizing its impact on patient outcomes.
Purpose of the Study:
- To systematically analyze morbidity and mortality conferences (MMCs).
- To capture the unique perspectives and lived experiences of MMC participants.
- To evaluate the effectiveness and roles of MMCs in anesthesia risk management.
Main Methods:
- Content analysis of MMC narratives from two university centers (June 1988 - June 1990).
- Qualitative examination of participant beliefs and experiences within the MMC setting.
- Categorization of participant perspectives to understand the "lived experience" of the MMC.
Main Results:
- Most MMCs were educational or informational (32% patient complications, 14% potential adverse incidents).
- Participant beliefs formed nine categories: knowledge disclosure, relationship, rule conformity, aplomb, litigation prep, ceremony, quality assurance, personal critique, and retribution.
- The MMC serves multiple cognitive and affective roles beyond its traditional perception.
Conclusions:
- Morbidity and mortality conferences (MMCs) are multifaceted, serving educational, quality assurance, and personal development functions.
- The term "morbidity and mortality conference" may be inaccurate; "case conference" or "clinical teaching conference" might be more fitting.
- Optimizing MMCs requires recognizing their diverse roles to enhance patient safety and outcomes.