From Morbidity and Mortality to Quality Improvement: Effects of a Structured and Interactive Otolaryngology Conference

Abstract

Objective: Measure the effects of a structured morbidity and mortality conference format on the attitudes of resident and faculty participants.

Study design: Prospective cohort study.

Setting: Otorhinolaryngology-head and neck surgery residency training program.

Subjects and methods: Two changes were implemented to the structure of our morbidity and mortality conference: (1) we adopted a recently described presentation framework called situation-background-assessment-recommendation and (2) appointed a faculty moderator to lead the conference. Surveys were distributed to residents and faculty before and after these modifications were implemented to measure changes in attitude of conference attendees.

Results: After implementing the above changes to the morbidity and mortality conference, participant engagement increased from "moderately engaged" to "extremely engaged" (P < .01). Among both faculty and residents, the perceived educational value of conference also improved from "moderately educational" to "extremely educational" (P < .01). Finally in the attending cohort, the impact on future patient care increased from "no change" to "greatly enhanced" (P < .01).

Conclusion: By implementing the situation-background-assessment-recommendation framework and appointing a faculty moderator to morbidity and mortality conference, participants reported significantly enhanced engagement during the conference, increased educational value of the session, and a positive impact on future patient care.

Keywords: SBAR; morbidity and mortality conference; quality improvement conference; situation-background-assessment-recommendation.

Figure 1.

Median participant response to survey questions regarding their morbidity and mortality (M&M) experience. Likert scale responses: 1 = most negative response; 5 = most positive response.