Morbidity and mortality conferences: Their educational role and why we should be there

Abstract

Background:This article examines the value of morbidity and mortality (M&M) conferences, and the multiple factors that contribute to their efficacy. Physicians’ morbidity and mortality conferences (M&MCs) focus on education by reviewing individual adverse events (AE), M&M. Alternatively, Quality Assurance (QA) conferences better examine system-wide issues (e.g., the role institutions play) in attaining or maintaining acceptable levels of patient care. Other issues examined in this review include: whether prospective vs. retrospective M&M data collection are more accurate, and how most states offer ‘nondiscovery’ of M&M proceedings.Methods:Most studies emphasize the educational role of M&MCs, and differentiate their role from QA. Studies comparing the accuracy of prospective vs. retrospective collection of M&M data were reviewed along with the medicolegal issues surrounding the protection of M&M data (‘nondiscovery’).Results:Multiple review articles emphasized that QA conferences typically identify system-wide failures (e.g., hospital policies) while M&MCs focus on physicians’ AE/morbidity/mortality. Additionally, the prospective collection of M&M data proved to be more accurate than retrospective analysis. Finally, most states protect M&M confidentiality (‘nondisclosure’); a glaring exception is Florida, ‘The Sunshine State,’ that allows ‘full disclosure.’Conclusion:This study reviews how M&MCs, differentiated from QA meetings, and educate physicians. It also documents how prospective collection of M&M data is more accurate than retrospective analysis. Additionally, it documents how in most states, medicolegal protections against discovery are in place, with Florida, the ‘Sunshine State’ remaining a glaring exception.

Morbidity and mortality meetings: gold, silver or bronze?

“…Barriers that are consistently identified across reviews include a focus on individuals rather than systems and variation in the structure and format of M&M meetings. As noted in prior reviews, our review also found limited evidence favouring a particular format or structure of M&M meetings. In light of the limited evidence demonstrating the superiority of one particular format over another, our review identified a set of enabling and inhibiting factors that can be applied to local settings.…”

A profile of morbidity and mortality rounds within resident training programs of the American College of Veterinary Surgeons

“…The inconsistencies in MMR formats among the various veterinary surgery programs is a weakness of veterinary MMR identified in this study, especially compared with human surgery training programs. Standardization of the review process and prospective, standardized data collection have been found to result in several benefits in human medicine, improving the accountability and quality of mortality data along with the identification of quality of care issues and supporting patient care quality improvement efforts, particularly for programs targeting the surgical patient . Standardizing the format of MMR has also been shown to improve residents' understanding of medical concepts presented in rounds .…”

New Horizons in Emergency Medicine Teaching and Training

“…Refs. [30][31][32] these conferences are arranged once a month as a departmental learning conferences where all the important cases with mortality and morbidity issues are collected and discussed. The candidate is asked to prepare the case and look at the current evidence to support the management done or best management which should have been given.…”