title: [Morbidity and mortality conference in general practice: about an experiment in Rhône-Alpes].
abstract: A morbidity and mortality conference (MMC) is a collective analysis, retrospective and systemic cases marked by occurrence of death, complication, or event that could cause harm to patient (adverse event).
  
  
  OBJECTIVE
  Its aim is the implementation and monitoring of actions to improve the care of patients and patient safety. A group for analysis of adverse events in general practice was created in 2011 in the Rhone-Alps, in order to test the feasibility of a MMC with general practitioners (GPs).
  
  
  METHODS
  A charter setting out the ethical framework and the terminology, methodology and the role of individual players was drafted. Then a group of volunteers was created among the members of an association of continuing medical education. Each session has been the subject of a report. The evaluation was conducted through interviews with participants, and with an electronic survey of satisfaction.
  
  
  RESULTS
  Since 2011, 12 physicians participated, analysing 36 cases during seven sessions. Reported events were most frequently interested women with a mean age of patients being 48 years (median 46 years). The situations reported were mixed (error diagnostic, therapeutic, adverse drug). Failures are related to care protocols, decision-making, the care environment (frequent disruptive pop) and human factors (caregiver stress). The participants were satisfied with the initiative. Analyses revealed some redundant causes that can be corrected to secure care. Beyond the non-stigmatising approach it may allow doctors to discuss their feelings without making them feel guilty (concept of second victim).
  
  
  CONCLUSIONS
  If such initiatives are still not widespread in ambulatory, they should be promoted by organizations. Openness to other caregivers in Ambulatory is a fundamental change desired by the GP. The National Programme for Patient Safety recently published in February 2013 mentions these aspects, emphasizing the key role of the DPC for acquisition techniques analysis of the causes by caregivers.
authors: Université de Lyon, EA santé-individu-société 4129, 69002 Lyon, France; Université de Lyon, 69000, Lyon, France; Université Lyon 1, département de médecine générale, 8, avenue Rockefeller, 69373 Lyon, France. Electronic address: chaneliere.marc@wanadoo.fr.
authors: Marc
authors: M
authors: Chanelière
authors: Christian
authors: C
authors: Comte
authors: Maud
authors: M
authors: Keriel-Gascou
authors: Valérie
authors: V
authors: Siranyan
authors: Cyrille
authors: C
authors: Colin
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003226:Congresses as Topic / Q000458:organization & administration*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control; D004502:Education, Medical, Continuing / Q000379:methods / Q000458:organization & administration; D005260:Female; D005602:France / Q000453:epidemiology; D058006:General Practice / Q000193:education / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D009026:Mortality / Q000639:trends*; D061214:Patient Safety / Q000592:standards / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D012189:Retrospective Studies