The Morbidity and Mortality Conference: A Century-Old Practice with Ongoing Potential for Future Improvement
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Published on: January 8, 2020
Marit S de Vos1, Merel J Verhagen2, Jaap F Hamming2
1Directorate of Quality and Patient Safety, Leiden University Medical Center, Rotterdam, the Netherlands.
Objective:
To discuss practical strategies to consider for morbidity and mortality conferences (M&M).
Materials And Methods:
This article reflects on (i) insights that can be drawn from the M&M literature, (ii) practical aspects to consider when organizing M&M, and (iii) possible future directions for development for this long-standing practice for routine reflection.
Results:
M&M offers the opportunity to learn from past cases in order to improve the care delivered to future patients, thereby serving both educational and quality improvement purposes. For departments seeking to implement or improve local M&M practice, it is difficult that a golden standard or best practice for M&M is nonexistent. This is partly because comparative research on different formats is hampered by the lack of objective outcome measures to evaluate the effectiveness of M&M. Common practical suggestions include the use of (i) a skillful and active moderator; (ii) structured formats for case presentation and discussion; and (iii) a dedicated committee to guide improvement plans that ensue from the meeting. M&M practice is affected by various sociological factors, for which qualitative research methods seem most suitable, but in the M&M literature these are sparsely used. Moreover, aspects influencing an open and blame-free atmosphere underline how local teams should tailor the format to best fit the local context and culture.
Conclusion:
This article presents practice guidance on how to organize and carry out M&M This practice for routine reflection needs to be tailored to the local setting, with attention for various sociological factors that are at play.
Insights
Morbidity and mortality (M&M) conferences offer valuable learning opportunities for improving patient care. Tailoring M&M practices to local contexts and sociological factors is crucial for effective quality improvement and education.
Area of Science:
- Medical Education
- Healthcare Quality Improvement
- Clinical Governance
Background:
- Morbidity and mortality (M&M) conferences are a long-standing practice for routine clinical reflection.
- M&M conferences serve dual purposes of education and quality improvement by analyzing past cases.
- There is a lack of a standardized best practice for M&M, hindering comparative research.
Purpose of the Study:
- To provide practical strategies for organizing and conducting effective morbidity and mortality conferences.
- To reflect on existing M&M literature, practical organization, and future development directions.
- To guide healthcare departments in implementing or enhancing local M&M practices.
Main Methods:
- Literature review of M&M practices and insights.
- Analysis of practical aspects for organizing M&M sessions.
- Consideration of sociological factors influencing M&M effectiveness.
Main Results:
- M&M conferences facilitate learning from past cases to enhance future patient care.
- Effective M&M relies on skilled moderators, structured case presentations, and dedicated improvement committees.
- Sociological factors and local context significantly influence M&M effectiveness, necessitating tailored approaches.
Conclusions:
- Guidance is provided for organizing and executing M&M conferences.
- M&M practices require customization to local settings, considering sociological dynamics.
- Fostering a blame-free atmosphere is essential for successful M&M implementation.
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