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At the Crossroad with Morbidity and Mortality Conferences: Lessons Learned through a Narrative Systematic Review


Affiliations
1 Department of Gastroenterology, University of Toronto, Toronto, ON, Canada
2 Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
3 Department of Internal Medicine and Department of Critical Care, McGill University Health Center, Montreal, QC, Canada
4 Department of Internal Medicine, McGill University Health Center, Montreal, QC, Canada
5 Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC, Canada
 

Objective: To determine the process and structure of Morbidity and Mortality Conference (MMC) and to provide guidelines for conducting MMC. Methods. Using a narrative systematic review methodology, literature search was performed from January 1, 1950, to October 2, 2012. Original articles in adult population were included. MMC process and structure, as well as baseline study demographics, main results, and conclusions, were collected. Results. 38 articles were included. 10/38 (26%) pertained to medical subspecialties and 25/38 (66%) to surgical subspecialties. 15/38 (40%) were prospective, 14/38 (37%) retrospective, 7/38 (18%) interventional, and 2/38 (5%) cross-sectional. The goals were quality improvement and education. Of the 10 medical articles, MMC were conducted monthly 60% of the time. Cases discussed included complications (60%), deaths (30%), educational values (30%), and system issues (40%). Recommendations for improvements were made frequently (90%). Of the 25 articles in surgery, MMCs were weekly (60% of the time). Cases covered mainly complications (72%) and death (52%), with fewer cases dedicated to education (12%). System issues and recommendations were less commonly reported. Conclusion: Fundamental differences existed in medical versus surgical departments in conductingMMC, although the goals remained similar.We provide a schematic guideline for MMC through a summary of existing literature.
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  • At the Crossroad with Morbidity and Mortality Conferences: Lessons Learned through a Narrative Systematic Review

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Authors

Xin Xiong
Department of Gastroenterology, University of Toronto, Toronto, ON, Canada
Teela Johnson
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
Dev Jayaraman
Department of Internal Medicine and Department of Critical Care, McGill University Health Center, Montreal, QC, Canada
Emily G. McDonald
Department of Internal Medicine, McGill University Health Center, Montreal, QC, Canada
Myriam Martel
Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC, Canada
Alan N. Barkun
Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC, Canada

Abstract


Objective: To determine the process and structure of Morbidity and Mortality Conference (MMC) and to provide guidelines for conducting MMC. Methods. Using a narrative systematic review methodology, literature search was performed from January 1, 1950, to October 2, 2012. Original articles in adult population were included. MMC process and structure, as well as baseline study demographics, main results, and conclusions, were collected. Results. 38 articles were included. 10/38 (26%) pertained to medical subspecialties and 25/38 (66%) to surgical subspecialties. 15/38 (40%) were prospective, 14/38 (37%) retrospective, 7/38 (18%) interventional, and 2/38 (5%) cross-sectional. The goals were quality improvement and education. Of the 10 medical articles, MMC were conducted monthly 60% of the time. Cases discussed included complications (60%), deaths (30%), educational values (30%), and system issues (40%). Recommendations for improvements were made frequently (90%). Of the 25 articles in surgery, MMCs were weekly (60% of the time). Cases covered mainly complications (72%) and death (52%), with fewer cases dedicated to education (12%). System issues and recommendations were less commonly reported. Conclusion: Fundamental differences existed in medical versus surgical departments in conductingMMC, although the goals remained similar.We provide a schematic guideline for MMC through a summary of existing literature.