Intérêt des revues de mortalité et de morbidité pour la formation des médecins et l’amélioration de la qualité et de la sécurité des soins : revue de la littérature

Abstract

In France, national incentives promote the development of morbidity and mortality conferences (M&MC) in hospitals. A systematic literature review was performed to investigate the effectiveness of M&MC as well as how they were conducted and how participants experienced them. The review was carried out by searching the MEDLINE and PASCAL databases and included articles in English and French. The following keywords were used: mortality, morbidity, conference, rounds, review, meetings, committee. Two independent reviewers selected all original studies describing or evaluating M&MC and published from 1st January 2002 through 31st December 2008. We analyzed 17 articles, of which 11 reported structured interviews, 3 analyzed M&MC minutes, 2 monitored indicators, and 1 described observations of M&MC. They showed good physician participation and a wide variety of types of meeting organization. Attendance by paramedical staff, the number of cases covered per meeting, and case selection criteria affected their content. Studies of the efficacy of M&MC were rare and concerned specific topics (digestive endoscopy and childbirth). Both the methods and the objectives of studies analyzing M&MC are heterogeneous. The published studies viewed M&MC as a valuable tool for physician education and quality assurance, but the factors associated with their effectiveness require further study.