Bal Gaëlle, David Sandra, Sellier Elodie, François Patrice
Unité de qualitique et d'évaluation médicale, CHU de Grenoble, 38043 Grenoble cedex 09, France.
Presse Med. 2010 Feb;39(2):161-8. doi: 10.1016/j.lpm.2009.11.005. Epub 2010 Jan 12.
In France, national incentives promote the development of morbidity and mortality conferences (M&MC) in hospitals.
A systematic literature review was performed to investigate the effectiveness of M&MC as well as how they were conducted and how participants experienced them.
The review was carried out by searching the MEDLINE and PASCAL databases and included articles in English and French. The following keywords were used: mortality, morbidity, conference, rounds, review, meetings, committee.
Two independent reviewers selected all original studies describing or evaluating M&MC and published from 1st January 2002 through 31st December 2008.
We analyzed 17 articles, of which 11 reported structured interviews, 3 analyzed M&MC minutes, 2 monitored indicators, and 1 described observations of M&MC. They showed good physician participation and a wide variety of types of meeting organization. Attendance by paramedical staff, the number of cases covered per meeting, and case selection criteria affected their content. Studies of the efficacy of M&MC were rare and concerned specific topics (digestive endoscopy and childbirth).
Both the methods and the objectives of studies analyzing M&MC are heterogeneous.
The published studies viewed M&MC as a valuable tool for physician education and quality assurance, but the factors associated with their effectiveness require further study.
在法国,国家激励措施推动了医院发病率和死亡率会议(M&MC)的发展。
进行系统的文献综述,以调查发病率和死亡率会议的有效性,以及会议的开展方式和参与者的体验。
通过检索MEDLINE和PASCAL数据库进行综述,纳入英文和法文文章。使用了以下关键词:死亡率、发病率、会议、查房、综述、会议、委员会。
两名独立评审员选择了所有描述或评估发病率和死亡率会议且于2002年1月1日至2008年12月31日发表的原创研究。
我们分析了17篇文章,其中11篇报告了结构化访谈,3篇分析了发病率和死亡率会议记录,2篇监测了指标,1篇描述了发病率和死亡率会议的观察情况。这些文章显示医生参与度高,会议组织形式多样。医护辅助人员的参与情况、每次会议涵盖的病例数以及病例选择标准影响了会议内容。关于发病率和死亡率会议疗效的研究很少,且涉及特定主题(消化内镜检查和分娩)。
分析发病率和死亡率会议的研究方法和目标各不相同。
已发表的研究将发病率和死亡率会议视为医生教育和质量保证的宝贵工具,但与其有效性相关的因素需要进一步研究。