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Chief physicians’ perceived need for improvement of morbidity and mortality conferences: the role of structural and procedural characteristics
  1. David L B Schwappach1,2,
  2. Lynn Häsler1,
  3. Yvonne Pfeiffer1
  1. 1 Swiss Patient Safety Foundation, Zürich, Switzerland
  2. 2 Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
  1. Correspondence to Professor David L B Schwappach, Swiss Patient Safety Foundation, Zürich 8032, Switzerland; schwappach{at}


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.

  • M&MC
  • mortality and morbidity conference
  • clinical learning
  • organizational learning
  • patient safety

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  • Contributors DLBS, YP and LH provided substantial contributions to the conception of the work and the interpretation of data. DLBS conducted the statistical analysis and drafted the paper. LH and YP provided feedback and revised the manuscript critically. All authors approved the final manuscript. DLBS is guarantor.

  • Funding The study was supported by the Swiss Medical Association (FMH).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data sets generated and/or analysed during the current study are not publicly available due to protecting participant confidentiality but are available from the corresponding author on reasonable request.