title: Web-based morbidity and mortality conferencing: a model for rural medical education.
abstract: Transfer of patients from rural emergency departments to tertiary centers can improve outcomes. The transfer process is complex and often ad hoc, inefficient, duplicative, and frustrating to both patients and providers. Suboptimal transfer undermines quality of care, raises costs, and delays services. Unfortunately, the same barriers that make transfer necessary (limited resources, geographic isolation) also hamper effective review. In this article, we describe a Web-based, interactive morbidity and mortality conference series in which providers reviewed cases transferred from rural emergency departments to a tertiary center. Six case-review conferences were conducted over 8 months. Each involved an average of 20 providers representing a total of 7 hospitals. Learning resources (ie, care protocols, best practice reviews, literature reviews) were developed collaboratively and disseminated among participating hospitals following the case-review conferences. Participant responses were highly favorable: 100% found the case reviews "very useful" or "useful" and 100% strongly agreed that the reviews would improve quality of patient care. We conclude that Web-based technology can efficiently facilitate review of transfers and has the potential to positively impact patient care. Future studies should utilize standard validated survey instruments of a larger number of participants to better understand the impact of this intervention.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Department of Emergency Medicine, Lebanon, NH 03756, USA. sarah.n.pletcher@hitchcock.org
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Pletcher
authors.forename: Scott W
authors.initials: SW
authors.lastname: Rodi
mesh_terms: D034201:Computers, Handheld; D020375:Education, Distance / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods*; D006780:Hospitals, Rural; D006801:Humans; D007373:Interinstitutional Relations; D020407:Internet; D008281:Maine; D017145:Models, Educational; D009017:Morbidity; D009026:Mortality; D009513:New Hampshire; D010360:Patient Transfer; D015397:Program Evaluation; D014193:Trauma Centers; D014707:Vermont; D049269:Videoconferencing