Making the most of a Morbidity and Mortality meeting

Quiney, Gabriella; Colucci, Gianluca

doi:10.3233/jrs-210077

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Thus, gathering more experience also includes learning about the diagnosis and further progress of patients brought to hospital by EMS [2]. Currently, mortality and morbidity (M&M) conferences are one of the few recognized opportunities for gaining knowledge and receiving personal feedback on actions carried-out [3]. However, M&M conferences rarely take place and often only deal with special cases.…”

Section: Introductionmentioning

confidence: 99%

Improving Emergency Service Quality and Patient Safety Through the Use of Cross-Sectoral Digital Feedback Systems – An Overview

2023

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Background: Feedback is essential for personal and professional development, also in emergency services. However, EMS usually ends at the interface with the emergency department, thus, the long-term effect of initiated emergency measures often remains unclear for emergency personnel. Digital, data-driven tools providing systematic feedback on patients’ outcome may be valuable to improve emergency service quality and patient safety. Objectives: To provide an overview about current approaches for cross-sectoral digital feedback systems in EMS. Methods: Literature review in PubMed/MEDLINE and Google Scholar in accordance with the PRISMA statement. Results: The search resulted in 567 articles out of which only three were identified as eligible. In only one study cross-sectoral feedback was used to improve quality. Conclusion: Although feedback is described as a method for improving the quality of the rescue service and feedback is also considered in the description of the requirements for digitization, there seems to be no technical implementation of a cross-sectoral feedback system so far.

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Section: Introductionmentioning

confidence: 99%

Improving Emergency Service Quality and Patient Safety Through the Use of Cross-Sectoral Digital Feedback Systems – An Overview

2023

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Human factors in anaesthetic practice. Part 2: clinical implications

Lomax,

Catchpole,

Sutcliffe

2024

BJA Education

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Beyond the numbers: Classifying contributory factors and potentially avoidable adverse events in the gynaecology service of National Women's Health at Auckland District Health Board

Sathiyaselvan,

Harilall,

Blaj

et al. 2024

Aust NZ J Obst Gynaeco

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BackgroundAdverse events (AEs) during health care are common and may have long‐term consequences for patients. Although there is a tradition of reviewing morbidity and mortality in gynaecology, there is no recommended system for reporting contributory factors and potential avoidability.AimsTo identify factors that contributed to AEs in the gynaecology service at National Women's Health at Auckland District Health Board and to determine potential avoidability, with the use of a multidisciplinary morbidity review.Materials and MethodsContributory factors from a review of AEs in gynaecology services were identified and classified as organisational and/or management factors, personnel factors and barriers to patients accessing and engaging with care. Potential avoidability of the AE was also considered. A descriptive analysis of the morbidity review of patients who had an AE from 2019 to 2022 was undertaken.ResultsOne hundred and fifty‐three cases of AEs were reviewed and 77 (50.3%) were associated with contributory factors. Of all cases, 45 (29.4%) had organisational factors, 54 (35.3%) had personnel factors and patient factors resulting in barriers to care contributing to 11 (7.2%) cases. Sixty‐five cases (42.5%) were classified as potentially avoidable. Of these 65 cases, 38 (58.5%) had organisational factors, 48 (73.8%) had personnel factors and nine (13.9%) had barriers to care.ConclusionsThe AE review process reported 50.3% of AEs had contributory factors that were classified as organisational, personnel and barriers to patients accessing care and that 42.5% of the AEs were potentially avoidable. These reviews can be used for making recommendations that potentially lead to improvements in gynaecology.

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Making the most of a Morbidity and Mortality meeting

Cited by 3 publications

References 18 publications

Improving Emergency Service Quality and Patient Safety Through the Use of Cross-Sectoral Digital Feedback Systems – An Overview

Improving Emergency Service Quality and Patient Safety Through the Use of Cross-Sectoral Digital Feedback Systems – An Overview

Human factors in anaesthetic practice. Part 2: clinical implications

Beyond the numbers: Classifying contributory factors and potentially avoidable adverse events in the gynaecology service of National Women's Health at Auckland District Health Board

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