Morbidity and mortality conference is not sufficient for surgical quality control: Processes and outcomes of a successful attending Physician Peer Review committee

American Journal of Surgery
H David ReinesJean Donovan

Abstract

Physician Peer Review (PPR) is required by The Joint Commission to assure examination of individual and group outcomes. Although surgeons may utilize Morbidity and Mortality (M&M) conference, applying these data to determine Focused Professional Practice Evaluations involves outcomes review. A PPR Committee of senior surgeons was created. This report describes one institution's surgical PPR process and results. A two-year (2014-2015) retrospective review of significant non-trauma complications and unanticipated deaths evaluated by PPR was performed. A faculty questionnaire evaluated perceptions of quality outcomes reporting. Of 395 reviewed cases, almost half (48.9%) demonstrated no care improvement opportunities, 48.6% revealed possible improvements, 2% were deviations from standard of care, and 0.5% represented unacceptable care. Although most surgeons (94%) wanted to know their complication rates, only 41% reported maintaining an outcomes database. As a complement to M&M, PPR is a valuable tool in the evaluation of individual surgical quality and can be the basis for further quality improvement opportunities. This process has been largely successful; only a small number of significant concerns were discovered.

Citations

May 13, 2017·The Clinical Teacher
Nov 16, 2020·American Journal of Surgery·Douglas P SlakeyKelly Guglielmi
May 4, 2021·Journal of the American College of Surgeons·Chelsea P FischerClifford Y Ko
Sep 6, 2019·Mayo Clinic Proceedings. Innovations, Quality & Outcomes·Amit K MathurDavid Douglas

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