Incorporating NSQIP into Surgical Morbidity and Mortality Conference: Promoting an Environment of Education, Transparency, and Accountability

Introduction Surgical Morbidity and Mortality Conference (M&M) nationwide lacks a standardized structure. We compared implementation of NSQIP definitions to structure our M&M versus our current system of self-identification and review. Methods A prospective study was performed to compare the identification of adverse events and the educational value of our M&M conference before and after implementation of NSQIP definitions over 10 weeks. Chart review was performed of all cases to identify NSQIP defined M&Ms. Surveys were administered before and after intervention to assess educational value. All presented M&Ms were evaluated for adequate reporting of adverse events and areas for improvement. Survey and presentation data were compared using Student’s T or Mann-Whitney testing as appropriate. P-values \u3c.05 were considered significant. Results Pre-intervention, 15% of occurrences were identified compared to 81% post-intervention. One of three deaths pre-intervention was identified versus four of four identified post-intervention. Faculty, residents, and students found improved clarity and education content in cases presented as well as improved identification of etiology, learning points, and prevention of future adverse events (all P\u3c.01). Residents and faculty found the post-intervention model better identified and communicated adverse events (P=.02), opportunities for prevention (P=. 04), and promoted improved transparency (P\u3c.01) and inclusion of all adverse events (P\u3c.01). 85% of participants supported the changes in M&M conference. Conclusion Incorporation of NSQIP into M&M standardizes identification and discussion of adverse events thus identifying opportunities for improvement and augmenting educational content. Consideration of the use of NSQIP should be given to other surgical departmental M&Ms