Background Mortality and morbidity conferences (M&MCs) are used to retrospectively discuss adverse events. Recently, the focus of the M&MC shifted from a clinical learning tool to a forum for analysing events using systems-based approaches. The aim of this study was to explore the M&MC characteristics that are associated with perceived improvement needs reported by chief physicians.

Methods A cross-sectional survey among chief physicians assessed characteristics of currently implemented M&MCs in Switzerland (44 items). A summative score was developed covering information on procedural and structural characteristics commonly recommended for design of M&MCs.

Results Of 223 participants, 145 (65%) indicated that their M&MC could be improved. Regression analysis revealed that the score (ie, the sum of structural and procedural features of the M&MC) was associated with self-perceived need for improvement of M&MCs (OR=0.73, CI 0.62 to 0.85, P<0.001). Chief physicians who explicitly select cases for M&MC discussion which involve problems in cooperation had twice the odds of reporting a need for improvement (OR=1.99, CI 1.05 to 3.74, P=0.034).

Conclusion Our study provides important insights into the factors contributing to chief physicians’ evaluation of M&MCs. Offering support for addressing the procedural and structural features of the M&MCs may be a good lever to improve them.