Toward Best Practices for Surgical Morbidity and Mortality Conferences: A Mixed Methods Study

Area of Science:

• Medical Education
• Surgical Quality Improvement
• Healthcare Management

Background:

• Surgical morbidity and mortality (M&M) conferences are a cornerstone of surgical education and quality improvement.
• Practices and perceived effectiveness of M&M conferences can vary significantly across institutions.
• Understanding participant expectations versus experiences is crucial for optimizing M&M conferences.

Purpose of the Study:

• To assess the strengths and challenges of different formats for surgical morbidity and mortality (M&M) conferences.
• To compare participant expectations with their experiences in M&M conferences.
• To identify areas for improvement in M&M conference structure, process, and content.

Main Methods:

• A mixed-methods approach was employed, including local observations and surveys.
• Key domains of M&M practice (goals, structure, process/content) were assessed.
• Participant expectations and experiences were evaluated in two international teaching hospitals.

Main Results:

• M&M conferences were universally focused on education, aligning with participant expectations.
• However, significant gaps existed between participant expectations and experiences regarding quality improvement (QI) focus, mandatory faculty attendance, and clinical practice changes.
• Institutions with active moderators and QI committees reported more positive experiences with QI focus and practice changes.

Conclusions:

• Despite variations in M&M practices, unmet expectations regarding QI are common, suggesting universal challenges.
• While M&M conferences effectively serve educational goals, their function in driving QI needs enhancement.
• Sharing "best practices" for M&M conferences is essential to improve their value in enhancing surgical care.