title: Increasing reporting of adverse events to improve the educational value of the morbidity and mortality conference.
abstract: BACKGROUND
  The aim of this study was to investigate the impact of a validated complication proforma on surgical Morbidity and Mortality (M&M) conference reporting.
  
  
  METHODS
  The ACS-NSQIP (American College of Surgeons-National Surgical Quality Improvement Program) 30-day complication proforma, when implemented, previously showed a 25% increase in morbidity and a 50% increase in mortality reporting. A pilot study introducing the paper-based proforma was undertaken, collecting prospective M&M data for 2,094 of 2,209 colorectal, upper gastrointestinal, breast, and vascular inpatients (94.7% compliance). A comparative analysis using the proforma vs traditional M&M data collection was used to compare accuracy of M&M data reporting.
  
  
  RESULTS
  There was a 73% increase in morbidities reported using the proforma as compared with M&M reporting (547 vs 316), and an increase of 10.81% (37 vs 41) in the reporting of mortalities. Of those patients with morbidities (n = 278), 70.24% (n = 203) had at least 1 surgical intervention. The median length of stay in patients with morbidities was 12 vs 3 days in those with no morbidities.
  
  
  CONCLUSIONS
  We demonstrated that prospective standardized incident recording provides significantly more accurate assessment of M&M data compared with current reporting methods. This increased accuracy should favorably affect surgical performance indicators and casemix funding.
authors.affiliation: Department of Surgery, Galway University Hospital, Galway, Ireland. terri.mcveigh@gmail.com
authors.forename: Terri P
authors.initials: TP
authors.lastname: McVeigh
authors.forename: Peadar S
authors.initials: PS
authors.lastname: Waters
authors.forename: Ruth
authors.initials: R
authors.lastname: Murphy
authors.forename: Gerrard T
authors.initials: GT
authors.lastname: O'Donoghue
authors.forename: Ray
authors.initials: R
authors.lastname: McLaughlin
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kerin
mesh_terms: D003625:Data Collection / Q000379:methods* / Q000592:standards; D005568:Forms and Records Control; D017052:Hospital Mortality; D006753:Hospital Records / Q000592:standards / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D008499:Medical Records / Q000592:standards / Q000706:statistics & numerical data; D018024:Peer Review, Health Care; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D058996:Quality Improvement; D012308:Risk Management / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data