Quality Improvement Focused Morbidity and Mortality Rounds: An Integrative Review
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Published on: February 16, 2011
Kayla P Churchill1, Justin Murphy2, Nick Smith3
1Obstetrics and Gynecology, Faculty of Medicine, Eastern Health Memorial University, St. John's, CAN.
Abstract:
Morbidity and mortality conference (MMC) is a century-old tradition in medicine that was initially primarily focused on the review of surgical outcomes and errors. In recent years, the value of MMC in quality improvement (QI) and patient safety initiatives has been realized and incorporated into the MMCs of some disciplines and institutions. Despite this, there is a need for a standardized structure of MMC that emphasizes both QI and patient safety. The purpose of this integrative review is to synthesize the literature on MMC structure that is reflective of QI and patient safety. An integrative literature search was carried out using PubMed and MEDLINE. Abstracts were reviewed and non-relevant articles were excluded. Exclusion criteria were no mention of MMC, analysis of specific case, no focus on QI or patient safety, and non-English language. A total of 21 articles were identified for review. Articles were reviewed in their entirety for content regarding structuring of the MMC to reflect and further develop QI and patient safety. The follwing three themes emerged that were consistently identified as being important for restructuring MMCs: (1) the importance of careful case selection, (2) the format of discussion during the conferences, and (3) the action plans reflecting QI initiatives derived from the conferences. The review suggests that one standardized method of MMC implementation that encompasses the three pivotal themes should be developed. Further research needs to focus on instituting measures of effectiveness for the new MMC model.
Insights
Morbidity and mortality conferences (MMC) need a standardized structure focusing on quality improvement and patient safety. Key themes for restructuring include case selection, discussion format, and action plans for better patient care outcomes.
Area of Science:
- Medical Education
- Healthcare Quality Improvement
- Patient Safety
Background:
- Morbidity and mortality conferences (MMC) are traditional medical reviews, historically focused on surgical outcomes and errors.
- Recent recognition of MMC's value in quality improvement (QI) and patient safety (PS) has led to its integration in some institutions.
- A standardized structure for MMC emphasizing QI and PS is currently lacking.
Purpose of the Study:
- To synthesize existing literature on Morbidity and Mortality Conference (MMC) structures that effectively integrate quality improvement (QI) and patient safety (PS).
Main Methods:
- An integrative literature review was conducted using PubMed and MEDLINE databases.
- Articles were screened based on relevance to MMC, QI, and PS, with exclusion of non-English or non-relevant studies.
- A total of 21 articles were reviewed in depth to identify themes related to structuring MMCs for QI and PS.
Main Results:
- Three central themes emerged for restructuring MMCs: careful case selection, optimized discussion formats, and development of actionable QI initiatives.
- These themes were consistently identified as crucial for enhancing the impact of MMCs on patient care.
- The review highlights the need for a unified approach to MMC implementation.
Conclusions:
- A standardized MMC model incorporating case selection, discussion format, and action planning is recommended.
- Further research is necessary to develop and validate measures for assessing the effectiveness of this proposed MMC model.
- Implementing a structured MMC approach can significantly advance quality improvement and patient safety in healthcare settings.
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