Quality Improvement Through Morbidity and Mortality Meetings in Interventional Radiology: A Retrospective Review

To evaluate the role of morbidity and mortality (M&M) meetings in supporting quality improvement within interventional radiology (IR), by examining recommendations arising from meetings and their subsequent implementation.

A retrospective review of M&M meetings held between 2020 and 2023 within a multi-site IR service employing more than 20 consultant IRs. Cases were presented using a standardized format and open discussion encouraged. Meeting records were reviewed for procedure details, complications, morbidity or mortality and resulting recommendations. For analysis, cases were classified by their contributing factors and recommendations by their theme. Institutional guidelines and records were reviewed after at least a 12-month interval to determine whether recommendations had been successfully implemented, defined as documented adoption into institutional practice, such as protocol, policy or workflow changes.

A total of 139 cases were discussed, yielding 70 recommendations, of which 45 (64.3%) were successfully implemented. Cases with a process-related contributing factor were more likely to result in a recommendation (85.7%, adjusted OR 20.6, 95%CI 3.3-127.6, p=0.001), compared to those with procedure, device, patient, anesthesia or other department-related factors. Recommendations related to department processes were the most frequent (45.7%), and the most likely to be implemented (87.5%, p<0.001) when compared to those related to procedural technique, clinical management, scholarly activity or inter-departmental initiatives.

M&M meetings support identification and implementation of quality improvement measures in IR. A substantial proportion of cases discussed generate recommendations, of which a majority are subsequently implemented. Discussions related to process-related factors and recommendations for change in departmental processes are particularly productive.