Journal Article

Mortality and morbidity meetings: an untapped resource for improving the governance of patient safety?

Fulop, Naomi, Higginson, Juliet, Walters, Rhiannon

2012

Overview

IntroductionNational Health Service hospitals and government agencies are increasingly using mortality rates to monitor the quality of inpatient care. Mortality and Morbidity (M&M) meetings, established to review deaths as part of professional learning, have the potential to provide hospital boards with the assurance that patients are not dying as a consequence of unsafe clinical practices. This paper examines whether and how these meetings can contribute to the governance of patient safety.MethodsTo understand the arrangement and role of M&M meetings in an English hospital, non-participant observations of meetings (n=9) and semistructured interviews with meeting chairs (n=19) were carried out. Following this, a structured mortality review process was codesigned and introduced into three clinical specialties over 12 months. A qualitative approach of observations (n=30) and interviews (n=40) was used to examine the impact on meetings and on frontline clinicians, managers and board members.FindingsThe initial study of M&M meetings showed a considerable variation in the way deaths were reviewed and a lack of integration of these meetings into the hospital's governance framework. The introduction of the standardised mortality review process strengthened these processes. Clinicians supported its inclusion into M&M meetings and managers and board members saw that a standardised trust-wide process offered greater levels of assurance.ConclusionM&M meetings already exist in many healthcare organisations and provide a governance resource that is underutilised. They can improve accountability of mortality data and support quality improvement without compromising professional learning, especially when facilitated by a standardised mortality review process.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD,BMJ Group
• Subject: Accountability / Administrative Personnel - ethics / Administrative Personnel - psychology / Administrative Personnel - statistics & numerical data / Attitude of Health Personnel / audit and feedback / Clinical Governance / Collaboration / governance / Government agencies / Group Processes / Hospital Mortality - trends / Hospitals, Teaching - ethics / Humans / Interviews as Topic / Medical personnel / Medical Staff, Hospital - standards / Meetings / Morbidity / morbidity and mortality rounds / Mortality / Mortality and Morbidity meetings / mortality data / National Health Programs / Original Research / Patient safety / Patient Safety - standards / Peer review / Physicians / qualitative research / Quality Assurance, Health Care - methods / quality improvement / safety culture / Teaching hospitals / Trusts / Vital Statistics