Preventing patient harm via adverse event review: An APSA survey regarding the role of morbidity and mortality (M&M) conference |
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Authors: | Loren Berman Madelene Ottosen Elizabeth Renaud Belinda Hsi-Dickie Annie Fecteau David Skarda Adam Goldin Shawn Rangel KuoJen Tsao |
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Affiliation: | 1. Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803, USA;2. Sidney Kimmel College at Thomas Jefferson University, 1025 Walnut St #100, Philadelphia, PA 19107, USA;3. University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, 6410 Fannin St, Houston, TX 77030-3006, USA;4. Hasbro Children''s Hospital, Brown University, 593 Eddy St, Providence, RI 02903, USA;5. Boston Children''s Hospital, 300 Longwood Ave and Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA;6. Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada;7. University of Utah, 201 Presidents Cir, Salt Lake City, UT 84112, USA;8. Seattle Children''s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA;9. University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA |
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Abstract: | IntroductionPeer-review endeavors represent the continual learning environment critical for a culture of patient safety. Morbidity and mortality (M&M) conferences are designed to review adverse events to prevent future similar events. The extent to which pediatric surgeons participate in M&M, and believe M&M improves patient safety, is unknown.MethodsA cross-sectional survey of the American Pediatric Surgical Association membership was conducted to evaluate participation in and perception of M&M conferences. Closed and open-ended questions were provided to gauge participation and perceptions of M&M effectiveness. Standard frequency analyses and tests of associations between M&M program attributes and surgeons' perceptions of effectiveness were performed.ResultsThe response rate was 38% (353/928). Most surgeons (85%) reported that they always participate in M&M, but only 64% believe M&M is effective in changing practice or prevention of future adverse events. Effective M&Ms were more likely to emphasize loop closure, multidisciplinary participation, standardized assessment of events, and connection to quality improvement efforts.ConclusionsMost pediatric surgeons participate in M&M, but many doubt its effectiveness. We identified attributes of M&M conferences that are perceived to be effective. Further investigation is needed to identify how to optimally utilize peer-review programs to prevent adverse events and improve patient safety.Level of evidenceV. |
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Keywords: | for the Morbidity and mortality Patient safety Peer review Postoperative complications Quality improvement |
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