[Morbidity/mortality review: usefulness and shortcomings]

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Clinical Risk Management

Context:

• The Morbidity-Mortality Conference (MMC) is a HAS-validated process for analyzing deaths and complications to enhance care quality and safety.
• Despite its validation and potential use in physician recredentialing and hospital accreditation, data on MMC implementation in France is scarce.
• A regional project aimed to assess physicians' experiences and perceptions of the MMC methodology in clinical risk management.

Purpose:

• To investigate the current implementation and physician perceptions of the Morbidity-Mortality Conference (MMC) methodology in French hospitals.
• To identify barriers and facilitators to the adoption of the MMC for improving patient care and safety.
• To understand physician motivations for implementing the MMC, particularly concerning patient safety and surgical care management.

Summary:

• A survey of 150 hospitals in northern France revealed that only 11% formally use the MMC methodology, with most adverse event analysis occurring in informal meetings (76%) or mandatory reports (77%).
• Key barriers to MMC adoption include lack of knowledge (66%) and time (50%), while fear of litigation was minimal (1%).
• Physicians view adverse event analysis as crucial for improving patient care (90%) and education (61%), leading to protocol modifications (70%) and organizational changes (71%).

Impact:

• Findings highlight a significant gap between the recognized importance of structured adverse event analysis and its actual implementation via the MMC methodology.
• The study underscores the need for specific educational initiatives and support systems to facilitate MMC adoption.
• Physician motivation for MMC implementation is primarily driven by patient safety concerns, suggesting that emphasizing these benefits can promote wider acceptance and effective use.