Display options
Cite
Gonzalo JD, Yang JJ, Huang GC. Systems-based content in medical morbidity and mortality conferences: a decade of change. J Grad Med Educ. 2012;4(4):438-44doi: 10.4300/JGME-D-12-00016.1.
Gonzalo, J. D., Yang, J. J., & Huang, G. C. (2012). Systems-based content in medical morbidity and mortality conferences: a decade of change. Journal of graduate medical education, 4(4), 438-44. https://doi.org/10.4300/JGME-D-12-00016.1
Gonzalo, Jed D, et al. "Systems-based content in medical morbidity and mortality conferences: a decade of change." Journal of graduate medical education vol. 4,4 (2012): 438-44. doi: https://doi.org/10.4300/JGME-D-12-00016.1
Gonzalo JD, Yang JJ, Huang GC. Systems-based content in medical morbidity and mortality conferences: a decade of change. J Grad Med Educ. 2012 Dec;4(4):438-44. doi: 10.4300/JGME-D-12-00016.1. PMID: 24294419; PMCID: PMC3546572.
Copy Download .nbib Format: NLM
Share it on

J Grad Med Educ. 2012 Dec;4(4):438-44. doi: 10.4300/JGME-D-12-00016.1.

Systems-based content in medical morbidity and mortality conferences: a decade of change.

Journal of graduate medical education

Jed D Gonzalo, Julius J Yang, Grace C Huang

PMID: 24294419 PMCID: PMC3546572 DOI: 10.4300/JGME-D-12-00016.1

Abstract

BACKGROUND: Following the Accreditation Council for Graduate Medical Education recommendations in 1999 to foster education in the systems-based practice (SBP) competency by examining adverse clinical events, institutions have modified the morbidity and mortality conference (MMC) to increase SBP-related discussion. We sought to examine the extent to which SBP-related content has increased in our department's MMCs compared with MMCs 10 years prior.

METHOD: We qualitatively analyzed audio recordings of our MMCs during 2 academic years, 1999-2000 (n  =  30) and 2010-2011 (n  =  30). We categorized comments and questions from moderators and faculty as SBP or non-SBP and characterized conferences by whether adverse events were presented and which systems issues were discussed.

RESULTS: Compared with MMCs in 1999-2000, present-day MMCs included a greater average percentage of SBP comments stated (69% versus 12%; P ≤ .001) and questions asked (13% versus 1%; P  =  .001) by the moderator, SBP comments stated (44% versus 4%; P ≤ .001) and questions asked (19% versus 1%; P ≤ .001) by faculty, and were more likely to present adverse events (87% versus 13%; P < .001). Interrater reliability for the distinction between SBP and non-SBP content was good (κ  =  0.647). Most common categories of systems issues discussed in 2010-2011 were critical laboratory value processing and reporting, institutional policies, and hospital-based factors.

CONCLUSIONS: Over the past decade, our MMC has transformed to include more discussion of SBP-related content and adverse events. The MMC can be used to educate residents in SBP and can also serve as a cornerstone for departmental quality and safety initiatives.

References

  1. Acad Med. 2002 Jul;77(7):750 - PubMed
  2. J Gen Intern Med. 2006 Nov;21(11):1192-4 - PubMed
  3. Acad Med. 2002 Oct;77(10):1001-6 - PubMed
  4. Acad Med. 2009 Mar;84(3):326-34 - PubMed
  5. J Am Med Assoc. 1947 Dec 6;135(14):881-4 - PubMed
  6. Ann R Coll Surg Engl. 1988 Nov;70(6):363-5 - PubMed
  7. Am J Med. 2010 Jul;123(7):663-8 - PubMed
  8. Am J Med. 2008 Oct;121(10):922-9 - PubMed
  9. JAMA. 2003 Dec 3;290(21):2838-42 - PubMed
  10. Med Humanit. 2010 Dec;36(2):108-11 - PubMed
  11. J Gen Intern Med. 2003 Aug;18(8):656-8 - PubMed
  12. South Med J. 1985 Jan;78(1):1-3 - PubMed
  13. J Emerg Med. 2010 May;38(4):507-11 - PubMed
  14. Acad Med. 2012 Apr;87(4):403-10 - PubMed
  15. Acad Med. 2004 Jan;79(1):83-8 - PubMed
  16. Teach Learn Med. 2009 Jul;21(3):233-9 - PubMed
  17. J Gen Intern Med. 2004 Aug;19(8):861-7 - PubMed
  18. Postgrad Med J. 2008 Apr;84(990):211-6 - PubMed

Publication Types