[Mortality-morbidity conferences: evaluation of an intervention to expand their practice in a university hospital]

Abstract

Background: Mortality-morbidity conferences (M&MC) are a recognized technique for evaluating and improving medical practices as well as improving patient safety.

Objectives: To describe the current practices for identification and management of care-related adverse events and to evaluate the effectiveness of an intervention to promote M&MC in a university hospital.

Methods: The study was designed as a before-and-after survey. In the first part of the survey (September-December 2004), we interviewed the heads of the clinical departments and units in a Parisian university hospital (n=37), using a semi-structured questionnaire. Questions concerned the management of adverse events or errors in their departments or units. The intervention took place during these interviews and consisted of providing information on methods currently available to improve inpatient safety, including broad-based M&MC. The second part involved a structured questionnaire sent by e-mail in December 2005.

Results: In 2004, 24 of the 37 departments discussed adverse events, 11 kept a register of them, and 9 used M&MC, mostly covering a specific limited segment of their specialty field. Only 2 used structured M&MC that covered the entire specialty field. In 2005, 3 departments had expanded the field covered by their M&MC, and 9 had established M&MC for their entire field (n=12). Six departments had not changed the field of their M&MC and 14 had not introduced it.

Conclusion: Our survey of department heads allowed us both to collect information about the methods they used for managing and evaluating adverse events and to provide information to them. This intervention may have contributed to increasing and improving the use of M&MC.