Evaluation of the implementation of a quality improvement program through morbidity and mortality reviews in a developing country.

Autor:	Lahnaoui O; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Souadka A; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., El Ahmadi B; Anesthesia & Intensive Care Department, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Ghannam A; Anesthesia & Intensive Care Department, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Belkhadir Z; Anesthesia & Intensive Care Department, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Amrani L; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Benkabbou A; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Mohsine R; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Majbar MA; Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital. Rabat, Morocco.; Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2022 Jun 24; Vol. 80, pp. 103987. Date of Electronic Publication: 2022 Jun 24 (Print Publication: 2022).
DOI:	10.1016/j.amsu.2022.103987
Abstrakt:	Background: Morbidity and mortality reviews represent an opportunity to discuss adverse events and healthcare issues. Aim: Report the first experience of implementing a procedure of MMR, and assess its impact on quality improvement. Methods: From July 2019 to December 2019, members of the surgical and ICU departments designed and implemented a regular procedure of MMR. Cases of severe postoperative complications after curative resection for digestive cancer were selected to be presented by a surgical resident and discussed in an interdisciplinary conference following a standardized presentation based on an analysis tool adapted from the ALARM framework. Process was assessed by the number of MMRs held, number and type of recommendations issued and implemented. Results: Among 13 serious complications during the study period, 10 were discussed. The "Tasks" category was activated in 90% of the cases where lack or misuse of protocols was identified in 90% of the events discussed. Test results availability or accuracy were incarnated in 30% of cases. Poor communication was a contributing factor in 60% of the cases. Written medical records were defective in 40% of the cases. From 16 recommendations for improvement emitted, 87.5% (14/16) were translated into projects and successfully implemented. Conclusions: a standardized and regular procedure of morbidity and mortality reviews in a tertiary care facility in a developing country allowed a significant improvement in patient care through quality initiatives implementation. MMRs might be a strong tool for the improvement of surgical care particularly for low-mid income countries. Competing Interests: All authors declare no conflict of interest. (© 2022 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.)
Databáze:	MEDLINE
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