Department of Medical Education, Chiba University Graduate School of Medicine, Japan.
Department of Patient Safety, Chiba University Hospital, Japan.
Intern Med. 2024 May 15;63(10):1361-1366. doi: 10.2169/internalmedicine.2418-23. Epub 2023 Oct 6.
Objective This study evaluated the implementation status of morbidity and mortality conferences in internal medicine specialty training programs in Japan. Methods This cross-sectional study surveyed hospitals in Japan with certified internal medicine specialty training programs. Program directors or equivalently responsible physicians managing certified internal medicine training programs were invited to participate in this study (n=619). Materials Data were collected using an online questionnaire that included questions about the number of morbidity and mortality conferences, types of cases covered, collaboration of the patient safety section and other health professions, and whether or not the conferences were conducted by a subspecialty department-led or program-based. Results Responses were received from 123 hospitals (19.8% response rate), of which 59 (48%) had some form of internal medicine morbidity and mortality conference in place. The average number per year was 9.63 (standard deviation: 18.12). Hospitals with morbidity and mortality conferences in subspecialty departments held significantly more conferences. Furthermore, the involvement of the patient safety department tended to be associated with holding more conferences. Autopsy rates were significantly higher in hospitals with program-based internal medicine morbidity and mortality conferences than subspecialty-led. Conclusion Internal medicine specialty training hospitals had more morbidity and mortality conferences than previously reported. Program-based morbidity and mortality conferences in internal medicine are associated with higher autopsy rates and may lead to an organizational reporting culture and lifelong learning attitudes that support patient safety. Collaboration with organizational management sections, such as patient safety, would be effective in implementing these conferences in internal medicine training programs.
目的 本研究评估了日本内科专科培训计划中发病率和死亡率会议的实施情况。
方法 本横断面研究调查了日本具有认证内科专科培训计划的医院。邀请了负责管理认证内科培训计划的主任或同等职位的医生（n=619）参与本研究。
材料 采用在线问卷收集数据，问卷内容包括发病率和死亡率会议的次数、涵盖的病例类型、患者安全部门与其他卫生专业人员的协作情况，以及会议是否由亚专科主导或基于计划进行。
结果 共收到 123 家医院的回复（19.8%的回复率），其中 59 家（48%）已开展某种形式的内科发病率和死亡率会议。每年的平均会议次数为 9.63 次（标准差：18.12）。在设有亚专科发病率和死亡率会议的医院中，会议次数明显更多。此外，患者安全部门的参与往往与更多的会议相关。在基于计划的内科发病率和死亡率会议中，尸检率明显高于亚专科主导的会议。
结论 内科专科培训医院的发病率和死亡率会议比之前报道的更多。内科基于计划的发病率和死亡率会议与更高的尸检率相关，可能会形成组织报告文化和支持患者安全的终身学习态度。与患者安全等组织管理部门合作，将有助于在内科培训计划中实施这些会议。
