[Value of morbidity and mortality review conferences for physician education and improvement of care quality and safety: a literature review]

Abstract

Background: In France, national incentives promote the development of morbidity and mortality conferences (M&MC) in hospitals.

Objective: A systematic literature review was performed to investigate the effectiveness of M&MC as well as how they were conducted and how participants experienced them.

Databases: The review was carried out by searching the MEDLINE and PASCAL databases and included articles in English and French. The following keywords were used: mortality, morbidity, conference, rounds, review, meetings, committee.

Study selection: Two independent reviewers selected all original studies describing or evaluating M&MC and published from 1st January 2002 through 31st December 2008.

Results: We analyzed 17 articles, of which 11 reported structured interviews, 3 analyzed M&MC minutes, 2 monitored indicators, and 1 described observations of M&MC. They showed good physician participation and a wide variety of types of meeting organization. Attendance by paramedical staff, the number of cases covered per meeting, and case selection criteria affected their content. Studies of the efficacy of M&MC were rare and concerned specific topics (digestive endoscopy and childbirth).

Study limitations: Both the methods and the objectives of studies analyzing M&MC are heterogeneous.

Conclusion: The published studies viewed M&MC as a valuable tool for physician education and quality assurance, but the factors associated with their effectiveness require further study.