Goals of Morbidity and Mortality meetings in paediatric acute care. A qualitative case study

Area of Science:

• Pediatric Acute Care
• Medical Education
• Healthcare Quality Improvement

Background:

• Morbidity and Mortality (M&M) meetings are standard in healthcare, often viewed as educational or quality improvement tools.
• However, their actual function and goals in pediatric acute care settings are complex and not fully understood.
• This complexity necessitates a deeper exploration of their perceived objectives.

Purpose of the Study:

• To explore the perceived goals of Morbidity and Mortality (M&M) meetings within the pediatric acute care context.
• To understand the nuances and potential conflicts in the objectives of these critical meetings.

Main Methods:

• Qualitative case study methodology was employed.
• Data collection involved semi-structured interviews with healthcare professionals and direct observation of M&M meetings.
• The study was conducted in a large pediatric quaternary hospital across six clinical departments.

Main Results:

• Two primary themes emerged: 'complex and nuanced goals' and 'tensions and contest between and within goals'.
• Identified goals included evaluating care, learning, support, adherence, and driving change, often in competition with each other.
• Participants perceived M&M meetings as valuable, serving a role beyond identifying measurable patient safety interventions.

Conclusions:

• Morbidity and Mortality (M&M) meetings in pediatric acute care possess multifaceted goals that extend beyond simple patient safety metrics.
• Optimizing meeting conduct and efficacy measurement requires a thorough understanding of these varied and sometimes conflicting objectives.
• These meetings significantly contribute to an embedded safety culture and the development of an informed, skilled healthcare workforce.