title: At the Crossroad with Morbidity and Mortality Conferences: Lessons Learned through a Narrative Systematic Review.
abstract: Objective. To determine the process and structure of Morbidity and Mortality Conference (MMC) and to provide guidelines for conducting MMC. Methods. Using a narrative systematic review methodology, literature search was performed from January 1, 1950, to October 2, 2012. Original articles in adult population were included. MMC process and structure, as well as baseline study demographics, main results, and conclusions, were collected. Results. 38 articles were included. 10/38 (26%) pertained to medical subspecialties and 25/38 (66%) to surgical subspecialties. 15/38 (40%) were prospective, 14/38 (37%) retrospective, 7/38 (18%) interventional, and 2/38 (5%) cross-sectional. The goals were quality improvement and education. Of the 10 medical articles, MMC were conducted monthly 60% of the time. Cases discussed included complications (60%), deaths (30%), educational values (30%), and system issues (40%). Recommendations for improvements were made frequently (90%). Of the 25 articles in surgery, MMCs were weekly (60% of the time). Cases covered mainly complications (72%) and death (52%), with fewer cases dedicated to education (12%). System issues and recommendations were less commonly reported. Conclusion. Fundamental differences existed in medical versus surgical departments in conducting MMC, although the goals remained similar. We provide a schematic guideline for MMC through a summary of existing literature.
authors.affiliation: Department of Gastroenterology, University of Toronto, Toronto, ON, Canada M5G 2C4.
authors.forename: Xin
authors.initials: X
authors.lastname: Xiong
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Teela
authors.initials: T
authors.lastname: Johnson
authors.affiliation: Department of Internal Medicine and Department of Critical Care, McGill University Health Center, Montreal, QC, Canada H3G 1A4; Jewish General Hospital, Montreal, QC, Canada H3T 1E2.
authors.forename: Dev
authors.initials: D
authors.lastname: Jayaraman
authors.affiliation: Department of Internal Medicine, McGill University Health Center, Montreal, QC, Canada H3G 1A4.
authors.forename: Emily G
authors.initials: EG
authors.lastname: McDonald
authors.affiliation: Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC, Canada H3G 1A4.
authors.forename: Myriam
authors.initials: M
authors.lastname: Martel
authors.affiliation: Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, QC, Canada H3G 1A4; Epidemiology and Biostatistics and Occupational Health, McGill University Health Center, McGill University, Montreal, QC, Canada H3G 1A4.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Barkun
mesh_terms: D003226:Congresses as Topic / Q000458:organization & administration* / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D009017:Morbidity; D009026:Mortality