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Published on: January 28, 2020
Implementation of multi-disciplinary morbidity, mortality and improvement conferences in oral and maxillofacial
Jianyao Huang1, Wenyi Shen2, Jinpeng Jiang3
1Department of Stomatology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang Province, China.
Abstract:
This study introduces multi-disciplinary morbidity, mortality and improvement conferences (MD-MM&ICs) to oral and maxillofacial surgery departments and reports the subsequent changes in the incidence of adverse events (AEs). From January 2020 to December 2022, using a reflective learning pathway, MD-MM&ICs were regularly conducted in the form of PPTs of reported cases by young surgeons. The preventive measures, early identification and treatments for AEs were summarized by causally categorizing the key factors for AEs, and postoperative AEs were recorded and classified according to the Clavien-Dindo classification, in order to evaluate the changes in the frequency of AEs and the severity of injuries in the ward after the implementation of MD-MM&ICs. A total of 262 AEs occurred, 68 MD-MM&ICs were conducted, and 122 AEs were reviewed in the meetings. Postoperative hemorrhage/hematoma and wound infection were common complications after oral and maxillofacial surgery, and 60% of surgery-related complications after flap surgery were serious complications (Clavien-Dindo Classification ≥ grade III). Upon the implementation of MD-MM&ICs, the number of AEs decreased year by year, along with serious complications related to the operation from 35.3% to 31.4%. Among them, the incidence of complications after flap surgery showed a trend of decreasing each year. By regularly conducting MD-MM&ICs, the ability of physicians at all levels, especially young physicians, to identify and respond to AEs can be improved. Furthermore, not only can the frequency of AEs be reduced but also the severity of patient injuries, thereby promoting patient medical safety.
Insights
Multi-disciplinary morbidity, mortality and improvement conferences (MD-MM&ICs) reduced adverse events (AEs) in oral surgery. Regular case reviews improved physician response to complications, enhancing patient safety.
Area of Science:
- Oral and Maxillofacial Surgery
- Medical Education
- Patient Safety
Background:
- Adverse events (AEs) are a significant concern in oral and maxillofacial surgery.
- Effective strategies are needed to reduce the incidence and severity of AEs.
- Current learning pathways may not adequately address AE prevention and management.
Purpose of the Study:
- To introduce multi-disciplinary morbidity, mortality and improvement conferences (MD-MM&ICs) in oral and maxillofacial surgery.
- To evaluate the impact of MD-MM&ICs on the incidence and severity of postoperative AEs.
- To assess the improvement in physician ability to identify and manage AEs.
Main Methods:
- Regular MD-MM&ICs were conducted using a reflective learning pathway with young surgeons presenting cases.
- AEs were recorded and classified using the Clavien-Dindo classification.
- Causal factors for AEs were identified to categorize preventive measures and treatments.
Main Results:
- A total of 262 AEs were recorded, with 122 reviewed in 68 MD-MM&ICs.
- Postoperative hemorrhage/hematoma and wound infection were common AEs.
- AE incidence and serious complications (Clavien-Dindo grade ≥ III) decreased from 35.3% to 31.4% after MD-MM&IC implementation.
- Complications following flap surgery showed a year-on-year decrease.
Conclusions:
- Regular MD-MM&ICs effectively reduce the frequency and severity of AEs in oral and maxillofacial surgery.
- These conferences enhance physicians' skills in AE identification and response, particularly for junior surgeons.
- Implementing MD-MM&ICs promotes improved patient safety and medical outcomes.
