Do regular morbidity and mortality conferences reduce preventable death rates? Our experience at Princess Marina Hospital

Mpapho J. Motsumi, Nkhabe Chinyepi, Samuel Rackara, Rashid Lwango, Getrude Kapinga, Karabo Ngwako, Maranatha Sentsho, Tefo Leshomo, Unami Chilisa, Pako Motlaleselelo, Elijah K. Lekgowe
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Abstract

Summary Background The role of morbidity and mortality conferences (M&MC) in surgical departments is to provide education and improve patient care. However, there is sparse evidence in the literature that M&MCs reduce preventable deaths. Therefore, this study aimed to assess the impact of routine M&MC on reducing the preventable death rate over 4 years at a tertiary hospital in Botswana. Methods This study used a quantitative research methodology. In this retrospective audit of the M&MC data, we collected all mortality data for the surgery department from the time the database started, July 2016, to December 2019. The department adopted and adapted the criteria and definitions of preventability based on the World Health Organization (WHO) guidelines for trauma quality improvement programs. We used the Pearson correlation statistic to evaluate the correlation between the time (years) since the start of routine M&MC and the preventable death rate. Ethical approval for the study was obtained. Results There were 4660 registered admissions from July 2016 to December 2019. Of these, 267 deaths were recorded, resulting in a crude mortality rate of 6%. Overall, the department considered 23% (61/267) of the deaths as preventable. A strong linear correlation ( R 2 = 0.982, p = 0.009) was found between the preventable death rate and time (years) since the commencement of routine M&MC. Trauma was the leading cause of preventable deaths (24.6%, 15/61). Conclusion Our findings suggest that routine M&MCs have the desired effect of reducing preventable death rates. Further studies are required to investigate this observed effect.

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定期召开发病率和死亡率会议能降低可预防的死亡率吗?我们在公主医院的经历
背景外科发病率和死亡率会议(M&MC)的作用是提供教育和改善患者护理。然而,文献中很少有证据表明M& mc减少了可预防的死亡。因此,本研究旨在评估博茨瓦纳一家三级医院4年来常规M&MC对降低可预防死亡率的影响。方法采用定量研究方法。在对M&MC数据的回顾性审计中,我们收集了从数据库启动时间(2016年7月至2019年12月)外科的所有死亡率数据。该部门采用并调整了基于世界卫生组织(WHO)创伤质量改善计划指南的可预防性的标准和定义。我们使用Pearson相关统计来评估自常规M&MC开始的时间(年)与可预防死亡率之间的相关性。该研究获得了伦理批准。结果2016年7月至2019年12月共登记入院4660人。其中,有267人死亡,导致粗死亡率为6%。总的来说,该部门认为23%(61/267)的死亡是可以预防的。可预防死亡率与开始常规MC的时间(年)之间存在较强的线性相关(R 2 = 0.982, p = 0.009)。创伤是可预防死亡的主要原因(24.6%,15/61)。结论我们的研究结果表明,常规M&MCs具有降低可预防死亡率的预期效果。需要进一步的研究来调查这种观察到的影响。
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