Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study

Abstract : BACKGROUND: The aim of this study was to identify the characteristics of morbidity and mortality conferences (MMCs) associated with the implementation of patient health-care quality and safety improvement initiatives. METHODS: We conducted an observational study of MMCs and followed up improvement initiatives for 1 year. Data on MMC baseline characteristics were abstracted using document analysis and observation of a meeting in three university hospitals in France (Grenoble, Nice, and Cochin [Paris] hospitals). Fifty-nine MMCs were included in medical (n = 24), surgical (n = 21), and anesthesiology and/or intensive care (n = 14) departments. An effectiveness index was computed by summing a composite score for each initiative pertaining to the MMC. RESULTS: Overall, 282 initiatives were identified in 42 MMCs. During the follow-up period, 215 initiatives (76%) were totally or partially implemented and the impact was evaluated for 73 (26%). An effectiveness index higher than the median (i.e., ≥10) was associated with a standardized presentation of cases (81% versus 29%, p <0.001), recording of improvement initiatives (94 versus 57, p = 0.001), the existence of an annual activity report (94% versus 68%, p = 0.01), the prior dissemination of a meeting agenda (71% versus 36%, p = 0.007), longer meeting duration (109 versus 80 min, p = 0.005), anesthesiology and/or intensive care specialty (39% versus 7%, p = 0.02), a theme-focused MMC (29% versus 4 %, p = 0.01), and a thorough analysis of failures (58% versus 25%, p = 0.01). CONCLUSIONS: This study suggests that the implementation of improvement initiatives relates to MCC characteristics. Recommendations for developing more effective patient safety-oriented MMCs can be proposed.
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Patrice François, Frédéric Prate, Gwenaëlle Vidal-Trecan, Jean-François Quaranta, Jose Labarere, et al.. Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study. BMC Health Services Research, BioMed Central, 2016, 16, pp.35. ⟨10.1186/s12913-016-1279-8⟩. ⟨inserm-02072789⟩

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