Morbidity and mortality conference

Morbidity and mortality (M&M) conferences are traditional, recurring conferences held by medical services at academic medical centers, most large private medical and surgical practices, and other medical centers. They are usually peer reviews of mistakes occurring during the care of patients. The objectives of a well-run M&M conference are to learn from complications and errors, to modify behavior and judgment based on previous experiences, and to prevent repetition of errors leading to complications. Conferences are non-punitive and focus on the goal of improved patient care. The proceedings are generally kept confidential by law. M&M conferences occur with regular frequency, often weekly, biweekly or monthly, and highlight recent cases and identify areas of improvement for clinicians involved in the case. They are also important for identifying systems issues (e.g., outdated policies, changes in patient identification procedures, arithmetic errors, etc.) which affect patient care.

The results of a survey that endeavored to study the relevance and traits of morbidity and mortality conferences (M&MCs) in the spring of 1998 indicate that 90% of U.S. internal medicine training programs hold M&MCs. The majority of these conferences occur on a monthly basis, where an assigned leader reviews certain select cases that had unpredicted consequences or a suspected medical error. It was also reported that two-thirds of the hospitals use the M&MCs as a means to fulfill their administrative requirements for quality assurance.

Morbidity and Mortality conferences have long been part of the practice of medicine, having originated in the early 1900s with Ernest Codman at Massachusetts General Hospital in Boston. He lost his staff privileges there after suggesting the evaluating of surgeon competence. Codman's ideas contributed to the standardization of hospital practices — including a case report system that ascribed responsibility for adverse outcomes — by the American College of Surgeons in 1916. As the medical profession evolved, physicians grew accustomed to discussing their errors at mortality conferences, where autopsy findings were presented, and in published case reports. By 1983, the ACGME began requiring that accredited residency programs conduct a weekly review of all complications and deaths.

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