title: Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study.
abstract: BACKGROUND
  The aim of this study was to identify the characteristics of morbidity and mortality conferences (MMCs) associated with the implementation of patient health-care quality and safety improvement initiatives.
  
  
  METHODS
  We conducted an observational study of MMCs and followed up improvement initiatives for 1 year. Data on MMC baseline characteristics were abstracted using document analysis and observation of a meeting in three university hospitals in France (Grenoble, Nice, and Cochin [Paris] hospitals). Fifty-nine MMCs were included in medical (n = 24), surgical (n = 21), and anesthesiology and/or intensive care (n = 14) departments. An effectiveness index was computed by summing a composite score for each initiative pertaining to the MMC.
  
  
  RESULTS
  Overall, 282 initiatives were identified in 42 MMCs. During the follow-up period, 215 initiatives (76%) were totally or partially implemented and the impact was evaluated for 73 (26%). An effectiveness index higher than the median (i.e., ≥10) was associated with a standardized presentation of cases (81% versus 29%, p <0.001), recording of improvement initiatives (94 versus 57, p = 0.001), the existence of an annual activity report (94% versus 68%, p = 0.01), the prior dissemination of a meeting agenda (71% versus 36%, p = 0.007), longer meeting duration (109 versus 80 min, p = 0.005), anesthesiology and/or intensive care specialty (39% versus 7%, p = 0.02), a theme-focused MMC (29% versus 4 %, p = 0.01), and a thorough analysis of failures (58% versus 25%, p = 0.01).
  
  
  CONCLUSIONS
  This study suggests that the implementation of improvement initiatives relates to MCC characteristics. Recommendations for developing more effective patient safety-oriented MMCs can be proposed.
authors.affiliation: Quality of Care Unit, University Hospital, and Research Unit, TIMC-IMAG (UMR 5525 CNRS/UJF-Grenoble 1), Grenoble, F-38043, France. pfrancois@chu-grenoble.fr.
authors.forename: Patrice
authors.initials: P
authors.lastname: François
authors.affiliation: Public Health Department, University Hospital, Nice, F-06003, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Prate
authors.affiliation: Public Health Unit: Risk Management and Quality of Care, Paris Centre University Hospital Group, AP-HP, and Research Unit, (INSERM U738), Paris Descartes University, Sorbonne Paris cite, Paris, F- 75014, France.
authors.forename: Gwenaëlle
authors.initials: G
authors.lastname: Vidal-Trecan
authors.affiliation: Public Health Department, University Hospital, Nice, F-06003, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Quaranta
authors.affiliation: Quality of Care Unit, University Hospital, and Research Unit, TIMC-IMAG (UMR 5525 CNRS/UJF-Grenoble 1), Grenoble, F-38043, France.
authors.forename: José
authors.initials: J
authors.lastname: Labarere
authors.affiliation: Quality of Care Unit, University Hospital, and Research Unit, TIMC-IMAG (UMR 5525 CNRS/UJF-Grenoble 1), Grenoble, F-38043, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Sellier
mesh_terms: D003422:Critical Care / Q000592:standards; D004059:Diffusion of Innovation; D005602:France; D006785:Hospitals, University; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D009017:Morbidity; D009026:Mortality; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety / Q000592:standards*; D011446:Prospective Studies; D058996:Quality Improvement / Q000592:standards; D011787:Quality of Health Care
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