Steady Establishment of Conferences on Perioperative Morbidity and Mortality - Continuous Assessment of Treatment and Process Quality

Objective: Systematic quality assessment in the form of conferences on morbidity and mortality (CMM) is established only in 1 quarter of medical departments. Another 55% discuss implementation but 20 percent never anticipated to start an according program. During launching period and first year of realization of a continuous CMM we analyzed contentment of participants, adherence to the program and implementability of results. Here, we report on our initiation of CMM, evaluation strategy, and results of clinical implementation.

Methods: All events of morbidity within our department were presented and discussed in a weekly scheduled manner. During 2 years of de-novo-establishment of CMM participants were asked to fill in blinded and standardized surveys for each meeting. Reasons for morbidity were scaled (surgical, medical, intensive care medicine, documentation, patient associated). Identified starting points for improvement (therapeutic adjudication, documentation, process optimization, communication) were prompted. Subjective valuation of respect to one another, emotional security and completeness of academic discussion were judged.

Results: Starting of the program was accompanied by a large scale of concerns in 66% of participants, great emphasis 30% of colleagues and disaffirmation in 4% of attendees. During the course of repetitive meetings attendance inclined to nearly 95%. CMM developed to be a meeting of general intent. 98% of CMM resulted in identification of balanced confounders for disastrous clinical course. 85% of discussed cases lead to suggestion of a specific plan for process-improvement. This was implemented in every day routine and valued regarding practicability. No participant complained on loss of respect to one another. Emotional security and reticence was reached in all CMMs.

Conclusion: Implementation of a steady and structured CMM demands continuous effort. Consequent development of results and implementation in clinical routine as well as emotional security is demanding but guarantees high adherence. CMM is a worthy tool for augmentation of quality and support of advanced training.