The value of voluntary morbidity and mortality meetings at a New Zealand metropolitan hospital.
OBJECTIVE
To assess the value and outcomes of contemporary, voluntary meetings reviewing the morbidity and mortality among surgical patients presenting at a New Zealand metropolitan hospital.


METHODS
Data on morbidity and mortality were prospectively collected and analysed over a two year period (March 2005-August 2007) from weekly departmental meetings. Patients were discussed on a patient by patient basis; the details and outcomes of this were formally constituted and documented into a database. Actual mortality numbers and unplanned returns to theatre were obtained from clinical coding. Consultant attendance was documented


RESULTS
Morbidity and mortality was recorded and discussed in 900 patients (6.5% of total admissions). Morbidity was discussed in 738 patients (incidence 5%); 190 (1.4%) deaths were discussed. Only 58% of unplanned returns to theatre and 62% of mortality recorded by clinical coding were discussed. However 54% of unplanned returns to theatre and 35% of mortality that were discussed were not recorded by clinical coding. It was felt that the clinical pathway had been appropriate in 88% and 91% of discussed morbidity and mortality, respectively. Over time, there was no significant change in consultant attendance (7/13 at 6 months vs 7/13 at 2 years, p=NS) and no trend in the median number of patients discussed per month.


CONCLUSIONS
In the setting of a voluntary morbidity and mortality meeting only 12% and 8% of patients discussed, respectively, resulted in further action being initiated. Despite there being significant under-reporting of both morbidity and mortality, this format identified data that had previously been missed by hospital coding. If value is gained from the morbidity and mortality meetings, it is not reflected in consultant attendance or in the number of patients submitted for discussion as these did not change over time.
Sakowska
Magdalena
M
Christchurch Public Hospital, PO Box 4345, Christchurch, New Zealand. magda.sakowska@cdhb.govt.nz
Connor
Saxon
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054869:Clinical Audit / Q000379:methods*; D003226:Congresses as Topic; D017052:Hospital Mortality; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D009520:New Zealand; D012086:Reoperation / Q000706:statistics & numerical data; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*