Directorate of Quality and Patient Safety, Leiden University Medical Center, Rotterdam, the Netherlands.
Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Eur J Pediatr Surg. 2023 Apr;33(2):114-119. doi: 10.1055/s-0043-1760836. Epub 2023 Jan 31.
To discuss practical strategies to consider for morbidity and mortality conferences (M&M).
This article reflects on (i) insights that can be drawn from the M&M literature, (ii) practical aspects to consider when organizing M&M, and (iii) possible future directions for development for this long-standing practice for routine reflection.
M&M offers the opportunity to learn from past cases in order to improve the care delivered to future patients, thereby serving both educational and quality improvement purposes. For departments seeking to implement or improve local M&M practice, it is difficult that a golden standard or best practice for M&M is nonexistent. This is partly because comparative research on different formats is hampered by the lack of objective outcome measures to evaluate the effectiveness of M&M. Common practical suggestions include the use of (i) a skillful and active moderator; (ii) structured formats for case presentation and discussion; and (iii) a dedicated committee to guide improvement plans that ensue from the meeting. M&M practice is affected by various sociological factors, for which qualitative research methods seem most suitable, but in the M&M literature these are sparsely used. Moreover, aspects influencing an open and blame-free atmosphere underline how local teams should tailor the format to best fit the local context and culture.
This article presents practice guidance on how to organize and carry out M&M This practice for routine reflection needs to be tailored to the local setting, with attention for various sociological factors that are at play.
讨论发病率和死亡率会议(M&M)中需要考虑的实用策略。
本文反思了(i)从 M&M 文献中得出的见解,(ii)组织 M&M 时需要考虑的实际方面,以及(iii)这种长期常规反思实践的可能未来发展方向。
M&M 提供了从过去的案例中学习的机会,以便改善未来患者的护理,从而达到教育和质量改进的双重目的。对于寻求实施或改进本地 M&M 实践的部门来说,M&M 不存在黄金标准或最佳实践,这是很困难的。这部分是因为缺乏客观的结果衡量标准来评估 M&M 的有效性,因此不同格式的比较研究受到阻碍。常见的实用建议包括使用(i)熟练且积极的主持人;(ii)案例陈述和讨论的结构化格式;以及(iii)专门的委员会来指导会议后随之而来的改进计划。M&M 实践受到各种社会学因素的影响,定性研究方法似乎最适合这些因素,但在 M&M 文献中,这些方法使用得很少。此外,影响开放和无责氛围的方面强调了当地团队应如何根据当地情况和文化调整格式。
本文提供了如何组织和进行 M&M 这种常规反思实践的实践指导。这种实践需要根据当地情况进行调整,同时要注意各种社会学因素的影响。