Electronic Voting to Improve Morbidity and Mortality Conferences

Area of Science:

• Surgery
• Medical Education
• Healthcare Quality Improvement

Background:

• Morbidity and mortality (M&M) meetings are crucial for surgical practice improvement and medical education.
• Identifying complication patterns and causes is vital in clinical surgery.
• Hierarchical structures and opinion leaders can introduce bias in M&M discussions.

Purpose of the Study:

• To assess if an electronic voting system could mitigate bias in M&M meetings.
• To evaluate the impact of anonymity on M&M discussions.
• To determine if electronic voting improves educational quality and participant satisfaction.

Main Methods:

• An interrupted time series study was conducted in a European tertiary care surgical department.
• Electronic voting was implemented in 412 M&M cases, compared to 330 conventional entries.
• Participant surveys, refined by principle component analysis, assessed educational quality and satisfaction before and after electronic voting implementation.

Main Results:

• Perceived educational quality significantly increased from 2.63 to 3.36 (p < 0.01).
• Participant satisfaction rose significantly from 2.6 ± 0.9 to 3.7 ± 1.2 (p < 0.01).
• The attribution of complications shifted from "patient's disease" to "misadventure" (p < 0.01).

Conclusions:

• Electronic voting in M&M meetings enhances perceived educational quality.
• Anonymity through electronic voting increases participant satisfaction.
• The system may alter the perceived causes of surgical complications.