Longitudinal Analysis of Morbidity and Mortality Conference Data for Head and Neck Cancer Patients. (23rd August 2013)

• Record Type: Journal Article
• Authors: Lai, Stephen Y.; Rashmi, Richa; Lewis, Carol M.; Hessel, Amy C.; Gidley, Paul W.; Skoracki, Roman; Weber, Randal S.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P69
• Page End: P69
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a109
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Morbidity and mortality (M&M) conferences are an important forum for discussing issues related to patient care and developing potential preventative actions. While this is a valuable educational venue, accurate collection of specific patient events also permits longitudinal analysis of these data that may improve the quality of patient care. Methods: We changed our reporting system for M&M conference cases in February 2009 by requiring weekly reporting of events by clinical trainees. A database was created to track specific events and associate them with specific surgeons, trainees, and procedures. Results: During a 2‐year period, we recorded 330 events (258 patients), which occurred during 4, 659 surgical procedures (overall complication rate: 7.1%). Leading categories of complications included hematologic/vascular (89, 26.9%), wound‐related (68, 20.6%), technical (55, 16.7%), and respiratory (42, 12.7%). One hundred and seven patients required a return to the operating room for intervention, and 29 patients needed hospital re‐admission for continued care. There were 10 mortalities on the service, but 2 of these patients did not have any surgical procedure (overall mortality rate: 0.2%). An initial subset analysis of patients requiring free‐flap reconstruction demonstrated 141 complications in 80 patients, which occurred during 672 surgical cases (11.9%). Conclusions: Active tracking of M&M conference cases provides a valuable practice‐based system for clinical education and internal auditing of the quality of patient care. Continued tracking of these data beyond this initial 2‐year foundation will provide a valuable internal benchmark to compare against available data and with institutional/national metrics of quality of care at the department and individual surgeon level.