Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Fort Sam Houston, Texas.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston.
JAMA Otolaryngol Head Neck Surg. 2017 Feb 1;143(2):135-140. doi: 10.1001/jamaoto.2016.2910.
To date, an otolaryngology-specific morbidity and mortality (M&M) conference has never been reported or evaluated.
To propose a novel otolaryngology-specific M&M format and to assess its success using a validated assessment tool.
DESIGN, SETTING, AND PARTICIPANTS: Preintervention and postintervention cohort study spanning 14 months (September 2014 to November 2015), with 32 faculty, residents, and medical students attending the department of otolaryngology M&M conference, conducted at the the San Antonio Uniformed Services Health Education Consortium.
A novel quality assurance conference was implemented in the department of otolaryngology at the San Antonio Uniformed Services Health Education Consortium. This conference incorporates patient safety reports, otolaryngology-specific quality metrics, and individual case presentations. The revised format integrates the Accreditation Council for Graduate Medical Education (ACGME) core competencies and Quality Improvement and Patient Safety (QI/PS) system. This format was evaluated by faculty, residents, and medical students every other month for 14 months to assess changes in attitudes regarding the M&M conference as well as changes in presentation quality.
Overall, 13 faculty, 12 residents, and 7 medical students completed 232 evaluations. Summary statistics of both resident and faculty attitudes about the success of the M&M format seem to improve over the 14 months between the prequestionnaires and postquestionnaires. General attitudes for both residents and faculty significantly improved from the pretest to posttest (odds ratio, 0.32 per month; 95% CI, 0.29-0.35). In the pretest period, "established presentation format" was considered the most necessary improvement, whereas in the posttest period this changed to "incorporate more QI." For resident presentations evaluated using the situation, background, assessment, and review/recommendations (SBAR) tool, all evaluations, from all participants, improved over time.
The M&M conference is an essential component of all otolaryngology residency programs and provides a unique opportunity to successfully incorporate the ACGME core competencies and regularly implement QI/PS.
迄今为止，从未有报道或评估过耳鼻喉科特定的发病率和死亡率（M&M）会议。
提出一种新的耳鼻喉科特定的 M&M 格式，并使用经过验证的评估工具评估其成功。
设计、地点和参与者：在 14 个月的时间里（2014 年 9 月至 2015 年 11 月）进行了干预前和干预后队列研究，共有 32 名教员、住院医师和医学生参加了圣安东尼奥统一服务健康教育联盟的耳鼻喉科 M&M 会议。
在圣安东尼奥统一服务健康教育联盟的耳鼻喉科实施了一种新的质量保证会议。该会议纳入了患者安全报告、耳鼻喉科特定的质量指标和个别病例介绍。修订后的格式整合了研究生医学教育认证委员会（ACGME）的核心能力和质量改进与患者安全（QI/PS）系统。这种格式每隔一个月由教员、住院医师和医学生评估 14 个月，以评估他们对 M&M 会议的态度变化以及演示质量的变化。
共有 13 名教员、12 名住院医师和 7 名医学生完成了 232 次评估。在预问卷和后问卷之间的 14 个月里，住院医师和教员对 M&M 格式成功的态度似乎有所改善。住院医师和教员的总体态度从测试前到测试后显著提高（优势比，每月 0.32；95%可信区间，0.29-0.35）。在测试前阶段，“建立演示格式”被认为是最需要改进的，而在后测试阶段，这一重点变成了“纳入更多的 QI”。对于使用情况、背景、评估和审查/建议（SBAR）工具评估的住院医师演示，所有参与者的所有评估都随着时间的推移而提高。
M&M 会议是耳鼻喉科住院医师培训计划的重要组成部分，为成功整合 ACGME 核心能力和定期实施 QI/PS 提供了独特的机会。
