Perspectives on Perioperative Team-Based Morbidity and Mortality Conferences: A Mixed Methods Study

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Medical Education

Background:

• Morbidity and mortality conferences (MMCs) are traditional quality improvement tools, typically involving single disciplines.
• There is a growing trend towards interprofessional team-based morbidity and mortality conferences (TBMMs) to enhance adverse event reviews.

Purpose of the Study:

• To investigate perioperative healthcare professionals' perspectives on MMCs and TBMMs.
• To identify barriers and facilitators for implementing TBMMs in healthcare settings.

Main Methods:

• A mixed-methods approach combining a national survey (N=1,466) and qualitative interviews/focus groups (N=14).
• Survey data analyzed using Kruskal-Wallis test; qualitative data analyzed via inductive thematic analysis.
• Concurrent triangulation of quantitative and qualitative data to provide comprehensive insights.

Main Results:

• Survey respondents generally viewed MMCs and TBMMs positively, citing respect, practice impact, and educational value.
• Nurses found TBMMs more educational but reported less comfort speaking up compared to surgeons and anesthesiologists.
• Qualitative findings revealed micro, meso, and macro-level barriers (e.g., negative interactions, leadership issues) and facilitators (e.g., relationships, leadership buy-in).

Conclusions:

• While perceptions of TBMMs are positive, significant implementation barriers persist.
• Enhancing inclusivity and optimizing the value of TBMMs requires further effort beyond simply inviting team members.
• Developing strategies to overcome identified barriers is crucial for advancing TBMM effectiveness.