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Beaulieu-Jones BR, Wilson S, Howard DS, Rasic G, Rembetski B, Brotschi EA, Pernar LI. Defining a High-Quality and Effective Morbidity and Mortality Conference: A Systematic Review. JAMA Surg 2023; 158:1336-1343. [PMID: 37851458 DOI: 10.1001/jamasurg.2023.4672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Importance Morbidity and mortality conferences (MMCs) are thought to advance trainee education, quality improvement (QI), and faculty development. However, there is considerable variability with regard to their completion. Objective To compile and analyze the literature describing the format, design, and other attributes of MMCs that appear to best advance their stated objectives related to QI and practitioner education. Evidence Review For this systematic review, a literature search with terms combining conference and QI or morbidity and mortality was performed in January 2022, using the PubMed, Embase, and ERIC (Education Resources Information Center) databases with no date restrictions. Included studies were published in English and described surgical or nonsurgical MMCs with explicit reference to quality or system improvement, education, professional development, or patient outcomes; these studies were classified by design as survey based, intervention based, or other methodologies. For survey-based studies, positively and negatively regarded attributes of conference design, format, and completion were extracted. For intervention-based studies, details of the intervention and their impact on stated MMC objectives were abstracted. Principal study findings were summarized for the other group. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Abstract screening, full-text review, and data extraction and analysis were completed between January 2022 and December 2022. Findings A total of 59 studies met appropriateness for study inclusion. The mean MERSQI score for the included studies was 6.7 (range, 5.0-9.5) of a maximum possible 18, which implied that the studies were of average quality. The evidence suggested that preparation and postconference follow-up regarding QI initiatives are equally as important as both (1) succinctly presenting case details, opportunities for improvement, and educational topics and (2) creating a constructive space for accountability, engagement, and multistakeholder discussion. Conclusions and Relevance These findings suggest that the published literature on MMCs provides substantial insight into the optimal format, design, and related attributes of an effective MMC. This systematic review provides a road map for surgical departments to improve MMCs in order to align their format and design with their principal objectives related to practitioner and trainee education, error prevention, and QI.
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Affiliation(s)
- Brendin R Beaulieu-Jones
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Spencer Wilson
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Daniel S Howard
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Ben Rembetski
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Erica A Brotschi
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Luise I Pernar
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
- Section of Minimally Invasive Surgery, Boston Medical Center, Boston University, Boston, Massachusetts
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Verhagen MJ, de Vos MS, Smaggus A, Hamming JF. Measuring What Matters at Morbidity and Mortality Conferences: A Scoping Review of Effectiveness Measures. J Patient Saf 2022; 18:e760-e768. [PMID: 35617601 DOI: 10.1097/pts.0000000000000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Efforts to study morbidity and mortality conferences (M&MC) are hampered by the lack of rigorous instruments to assess the effectiveness of the conferences for the purpose of quality improvement and medical education. This might limit further advancement of the practice. The aim of this scoping review was to determine commonly used effectiveness measures of M&MC in the literature. METHOD A scoping review was performed of quantitative, qualitative, and mixed methods studies of M&MC, using databases from PubMed, Emcare, Embase, Web of Science, and the Cochrane library. Studies were included if an outcome was described after a general evaluation or an intervention to M&MC. Study quality was assessed with the Quality Assessment Tool for Studies with Diverse Designs. RESULTS A total of 43 articles were included in the review. The majority used a quantitative (n = 23) or mixed (n = 17) design, with surveys as the most frequent method used for data collection (n = 29). The overall Quality Assessment Tool for Studies with Diverse Designs scores were modest (64%). Outcome measures used to evaluate the effectiveness of M&MC were clustered in the following categories: "participant experiences," "characteristics of the meeting," "medical knowledge," "actions for improvement," and "clinical outcomes." CONCLUSIONS This review found a wide variety of effectiveness measures for M&MC. Rather than using isolated measures, approaches that combine multiple effectiveness measures could offer a more comprehensive assessment of M&MC. Although there was a preference for quantitative metrics, this fails to seize the opportunity of qualitative methods to yield insights into sociological purposes of M&MC, such as building professional identities and safety culture.
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Affiliation(s)
| | - Marit S de Vos
- Directorate of Quality and Patient Safety, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrew Smaggus
- Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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3
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Levy AE, Whittington MD, Anstett TJ, Simon ST, Wentworth A, Carter JE, Ho PM. A Systems-Based Morbidity and Mortality Conference Was Associated With a Transient Reduction in ECG Completion Times. Qual Manag Health Care 2022; 31:28-33. [PMID: 34724456 PMCID: PMC9050961 DOI: 10.1097/qmh.0000000000000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES During its monthly morbidity and mortality conference (MMC), the University of Colorado Division of Cardiology reviewed a "near-miss" patient safety event involving the delayed completion of a Stat-priority (ie, statim, meaning high priority) electrocardiogram (ECG). Because critical and interprofessional stakeholders participated in the conference, we hypothesized that the MMC would be associated with reduced ECG completion times. METHODS Data were collected for in-hospital ECGs performed at the University of Colorado Hospital between January 1, 2017, and June 30, 2018. An interrupted time series analysis was used to estimate the immediate and ongoing impact of the MMC (held on February 28, 2018) on ECG completion times, stratified by order priority (Stat, Now, or Routine). The percentage of delayed Stat-priority ECGs was analyzed as a secondary outcome. RESULTS Before the MMC, ECG completion times were stable for all order priorities ( P > .2), but the proportion of delayed Stat-priority ECGs increased from 5% in January 2017 to 20% in February 2018 ( P < .01). The MMC was associated with an immediate reduction in average daily ECG completion times for Routine (-18.4 minutes, P = .03) and Now (-8 minutes, P = .024) priority ECGs. No reduction was seen for Stat ECGs ( P = .97), though the percentage of delayed Stat ECGs stopped increasing ( P = .63). In the post-MMC period, completion times for Routine-priority ECGs increased and approached pre-MMC levels. CONCLUSIONS The MMC was associated with an immediate, but temporary, improvement in ECG completion times. Although the observed clinical benefit of the MMC is novel, these data support the need for more durable reforms to sustain initial improvements.
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Affiliation(s)
- Andrew E. Levy
- University of Colorado School of Medicine, Aurora, CO, USA
- Denver Health and Hospital Authority, Denver, CO, USA
| | | | | | | | | | | | - P. Michael Ho
- University of Colorado School of Medicine, Aurora, CO, USA
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4
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Morand GB, Anderegg N, Kleinjung T, Bohlender JE, Veraguth D, Broglie MA, Holzmann D, Huber AM, Röösli C, Soyka MB. Assessment of Surgical Complications With Respect to the Surgical Indication: Proposal for a Novel Index. Front Surg 2021; 8:638057. [PMID: 33681285 PMCID: PMC7930554 DOI: 10.3389/fsurg.2021.638057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/11/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: The Clavien–Dindo classification is a broadly accepted surgical complications classification system, grading complications by the extent of therapy necessary to resolve them. A drawback of the method is that it does not consider why the patient was operated on primarily. Methods: We designed a novel index based on Clavien–Dindo but with respect to the surgical indication. We surveyed an international panel of otolaryngologists who filled out a questionnaire with 32 real case-inspired scenarios. Each case was graded for the surgical complication, surgical indication, and a subjective rating whether the complication was acceptable or not. Results: Seventy-seven otolaryngologists responded to the survey. Mean subjective rating and surgical complication grading for each scenario showed an inverse correlation (r2 = 0.147, p = 0.044). When grading the surgical complication with respect to the surgical indication, the correlation with the subjective rating increased dramatically (r2 = 0.307, p = 0.0022). Conclusion: We describe a novel index grading surgical complications with respect to the surgical indication. In our survey, most respondents judged a complication as acceptable or not according to its grade but kept in mind the surgical indication. This subjective judgment could be quantified with our novel index.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Nanina Anderegg
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Jörg E Bohlender
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Dorothe Veraguth
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christof Röösli
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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5
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Poonia SK, Prasad A, Chorath K, Cannady SB, Kearney J, Ruckenstein M, Rajasekaran K. Resident Safety Huddles: Our Department's Experience in Improving Safety Culture. Laryngoscope 2021; 131:E1811-E1815. [PMID: 33438757 DOI: 10.1002/lary.29384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE/HYPOTHESIS Our department sought to develop a quality improvement initiative in the interest of promoting resident involvement within the departmental safety culture. Specifically, we aimed to identify any barriers to incident reporting among residents and to create an approach to rectify this problem. STUDY DESIGN Patient Safety/Quality Improvement. METHODS This is a descriptive, qualitative study taking place at a large teaching hospital. A brief survey was administered to all Otorhinolaryngology residents and based on feedback a two-pronged approach to creating a patient safety and quality improvement curriculum was undertaken. This entailed implementation of 1) a formalized online curriculum and 2) a resident-driven forum for discussion of safety concerns termed a "Resident Safety Huddle." RESULTS The survey identified three main barriers to incident reporting among residents, including increased workload, the punitive nature of the system, and fear of retribution. During the study period, the residents completed the curriculum required to obtain the Institute for Healthcare Improvement Basic Certificate of Quality and Safety and participated in 10 Resident Safety Huddles. Each huddle was dedicated to discussion of a unique safety concern and frequently led to sustainable solutions. After implementation of this curriculum, an increase in the number of safety events reported by residents was recognized. CONCLUSIONS In building an educational foundation for incident reporting and further bolstering it with a resident-driven forum for discussion of safety concerns, we were able to achieve a recognizable and meaningful impact on our residents and the greater departmental safety culture. LEVEL OF EVIDENCE 4 (single descriptive or qualitative study) Laryngoscope, 131:E1811-E1815, 2021.
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Affiliation(s)
- Seerat K Poonia
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Aman Prasad
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Kevin Chorath
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Steven B Cannady
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - James Kearney
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Michael Ruckenstein
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
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6
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Churchill KP, Murphy J, Smith N. Quality Improvement Focused Morbidity and Mortality Rounds: An Integrative Review. Cureus 2020; 12:e12146. [PMID: 33489558 PMCID: PMC7813522 DOI: 10.7759/cureus.12146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Morbidity and mortality conference (MMC) is a century-old tradition in medicine that was initially primarily focused on the review of surgical outcomes and errors. In recent years, the value of MMC in quality improvement (QI) and patient safety initiatives has been realized and incorporated into the MMCs of some disciplines and institutions. Despite this, there is a need for a standardized structure of MMC that emphasizes both QI and patient safety. The purpose of this integrative review is to synthesize the literature on MMC structure that is reflective of QI and patient safety. An integrative literature search was carried out using PubMed and MEDLINE. Abstracts were reviewed and non-relevant articles were excluded. Exclusion criteria were no mention of MMC, analysis of specific case, no focus on QI or patient safety, and non-English language. A total of 21 articles were identified for review. Articles were reviewed in their entirety for content regarding structuring of the MMC to reflect and further develop QI and patient safety. The follwing three themes emerged that were consistently identified as being important for restructuring MMCs: (1) the importance of careful case selection, (2) the format of discussion during the conferences, and (3) the action plans reflecting QI initiatives derived from the conferences. The review suggests that one standardized method of MMC implementation that encompasses the three pivotal themes should be developed. Further research needs to focus on instituting measures of effectiveness for the new MMC model.
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Affiliation(s)
- Kayla P Churchill
- Obstetrics and Gynecology, Faculty of Medicine, Eastern Health Memorial University, St. John's, CAN
| | - Justin Murphy
- Orthopedic Surgery, Memorial University of Newfoundland, St. John's, CAN
| | - Nick Smith
- Orthopedic Surgery, Faculty of Medicine, Eastern Health Memorial University, St. John's, CAN
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7
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Brenner MJ, Chang CWD, Boss EF, Goldman JL, Rosenfeld RM, Schmalbach CE. Patient Safety/Quality Improvement Primer, Part I: What PS/QI Means to Your Otolaryngology Practice. Otolaryngol Head Neck Surg 2019; 159:3-10. [PMID: 29968525 DOI: 10.1177/0194599818779547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Patient safety/quality improvement (PS/QI) is the cornerstone of 21st-century health care. Otolaryngology-Head and Neck Surgery is excited to provide a dedicated PS/QI primer. The overarching goal for this PS/QI series is to provide a comprehensive and practical resource that assists readers, authors, and peer reviewers in understanding PS/QI research, its unique methodology, and the associated reporting standards for trustworthy performance measures. The target audience includes resident and fellows, faculty from the private sector and academia, and allied health professionals. This inaugural primer reviews PS/QI background as it relates to otolaryngology practice. It explores the history, goals, and development of performance measurement. In addition, it highlights opportunities for integrating PS/QI into otolaryngology practice. Payers will drive patients to quality care based on outcomes. Otolaryngologists have a responsibility to embrace a culture of PS/QI. In doing so, we will define optimal, quality otolaryngology care through objective data and metrics.
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Affiliation(s)
- Michael J Brenner
- 1 School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Emily F Boss
- 3 School of Medicine Johns Hopkins University, Baltimore, Maryland, USA
| | - Julie L Goldman
- 4 School of Medicine, University of Louisville, Louisville, Kentucky, USA
| | | | - Cecelia E Schmalbach
- 6 Roudebush Veterans Medical Center, School of Medicine, Indiana University, Indianapolis, Indiana, USA
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8
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Nussenbaum B, Chole RA. Rethinking Morbidity and Mortality Conference. Otolaryngol Clin North Am 2019; 52:47-53. [DOI: 10.1016/j.otc.2018.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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9
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Cramer JD, Graboyes EM, Brenner MJ. Mortality associated with tracheostomy complications in the United States: 2007-2016. Laryngoscope 2018; 129:619-626. [DOI: 10.1002/lary.27500] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2018] [Indexed: 11/09/2022]
Affiliation(s)
- John D. Cramer
- Department of Otolaryngology-Head and Neck Surgery; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Evan M. Graboyes
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
| | - Michael J. Brenner
- Department of Otolaryngology-Head and Neck Surgery; University of Michigan; Ann Arbor Michigan U.S.A
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10
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Jamal N, Bowe SN, Brenner MJ, Balakrishnan K, Bent JP. Impact of a Formal Patient Safety and Quality Improvement Curriculum: A Prospective, Controlled Trial. Laryngoscope 2018; 129:1100-1106. [DOI: 10.1002/lary.27527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Nausheen Jamal
- Department of Otolaryngology–Head and Neck SurgeryLewis Katz School of Medicine at Temple University Philadelphia Pennsylvania
| | - Sarah N. Bowe
- Department of Otolaryngology–Head and Neck SurgerySan Antonio Uniformed Services Health Education Consortium (SAUSHEC) Ft. Sam Houston TX
| | - Michael J. Brenner
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Michigan School of Medicine Ann Arbor Michigan
| | - Karthik Balakrishnan
- Mayo Clinic Children's Center and Department of OtorhinolaryngologyMayo Clinic Rochester Minnesota
| | - John P. Bent
- Department of Otorhinolaryngology–Head and Neck Surgery, Albert Einstein College of Medicine at Montefiore Medical Center Bronx New York U.S.A
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11
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Balakrishnan K, Arjmand EM, Nussenbaum B, Snyderman C. National Multispecialty Survey Results: Comparing Morbidity and Mortality Conference Practices within and outside Otolaryngology. Otolaryngol Head Neck Surg 2017; 158:273-279. [DOI: 10.1177/0194599817737993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective The objective is to describe variations in the otolaryngology morbidity and mortality (M&M) conference and to compare with other specialties. Design Cross-sectional survey. Setting The setting included otolaryngology departments across the United States and nonotolaryngology medical and surgical departments at 4 academic medical centers. Subjects and Methods Participants were members of a national otolaryngology quality/safety network and nonotolaryngology quality leaders at 4 large academic hospitals. Surveys were administered January 2017. Respondents described M&M conference practices, goals, and educational role. Results Twenty-eight of 39 individuals representing 28 institutions completed the otolaryngology survey (72% response rate). Of 197 individuals, 60 (30% response rate) representing 11 surgical and 20 nonsurgical specialties completed the comparison survey. Twenty-seven of 28 otolaryngologists (46 of 60 nonotolaryngologists) worked in academic settings. All otolaryngology programs conducted an M&M conference: 54% discussed all adverse events and errors; 32% used standard case selection processes; 70% used structured discussion, usually root cause analysis (64%); and 32% classified harm level. In comparison with other specialties, otolaryngology programs were more likely to discuss all adverse events and errors ( P = .01). Most conferences led to quality projects and intrainstitutional communication: 22% communicated to patients and families; 73% of respondents thought that M&M conferences should be standardized or use “best practices.” In both surveys, improving patient care was rated the conference’s most important function, followed by trainee education and culture change. Patient care and practice-based learning were rated the most relevant Accreditation Council for Graduate Medical Education Core Competencies in both surveys. Conclusions Academic otolaryngology M&M practices generally align with other specialties, but specifics vary widely, making collaborative quality improvement challenging. Educational and administrative priorities cross specialties. Most respondents thought that standardization and best practices are worthwhile. Nonacademic practice data are needed.
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Affiliation(s)
- Karthik Balakrishnan
- Department of Otorhinolaryngology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Ellis M. Arjmand
- Bobby Alford Department of Otolaryngology–Head & Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Brian Nussenbaum
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Carl Snyderman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Spielman DB, Hsueh WD, Choi KY, Bent JP. From Morbidity and Mortality to Quality Improvement: Effects of a Structured and Interactive Otolaryngology Conference. OTO Open 2017; 1:2473974X17692775. [PMID: 30480176 PMCID: PMC6239051 DOI: 10.1177/2473974x17692775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 12/22/2016] [Accepted: 01/18/2017] [Indexed: 11/16/2022] Open
Abstract
Objective Measure the effects of a structured morbidity and mortality conference format
on the attitudes of resident and faculty participants. Study Design Prospective cohort study. Setting Otorhinolaryngology–head and neck surgery residency training program. Subjects and Methods Two changes were implemented to the structure of our morbidity and mortality
conference: (1) we adopted a recently described presentation framework
called situation-background-assessment-recommendation and (2) appointed a
faculty moderator to lead the conference. Surveys were distributed to
residents and faculty before and after these modifications were implemented
to measure changes in attitude of conference attendees. Results After implementing the above changes to the morbidity and mortality
conference, participant engagement increased from “moderately engaged” to
“extremely engaged” (P < .01). Among both faculty and
residents, the perceived educational value of conference also improved from
“moderately educational” to “extremely educational” (P <
.01). Finally in the attending cohort, the impact on future patient care
increased from “no change” to “greatly enhanced” (P <
.01). Conclusion By implementing the situation-background-assessment-recommendation framework
and appointing a faculty moderator to morbidity and mortality conference,
participants reported significantly enhanced engagement during the
conference, increased educational value of the session, and a positive
impact on future patient care.
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Affiliation(s)
- Daniel B Spielman
- Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Wayne D Hsueh
- Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen Y Choi
- Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - John P Bent
- Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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