Focus on Systems to Improve Morbidity and Mortality Conference Relevance

Morbidity and mortality conference (MMC) is educationally important. However, resident physicians rate it less positively than faculty, citing focus on assigning blame rather than targeting change. Additionally, many MMC presentations are selected for clinical novelty instead of avoidable outcome. Despite significant time and resources routinely committed to MMC, its educational and clinical impact is generally limited. This warrants shifting focus toward quality improvement and systems-based care.

From July to December 2017, within a large, public academic center and medical school, the family medicine MMC became a quality conference (QC) focusing on thematically-linked, system-based errors. After case presentations, the audience split into small groups for targeted discussion then reconvened to identify specific interventions. We collected attitudinal data from faculty and resident physicians in attendance using real-time audience text polling, targeting case relevance and change impact.

Compared to MMC, QC case relevance improved by 0.39 (P<.01) on a 5-point scale. Compared to MMC, QC cumulatively approached but did not meet statistical significance regarding changing clinical practice. Qualitative statements commented on increased multilevel engagement, dedicated follow up, and decreased didactic presentations.

QC demonstrated statistically significant increased relevance compared to MMC, reflecting the benefit of systems-based, thematically-linked cases.