Teaming to Revitalize the Morbidity and Mortality Conference.

Abstract

Problem: Teaming is a conceptual approach to collaboration in dynamic environments. The internal medicine (IM) morbidity and mortality conference (M&M) is an environment where dynamic collaboration is essential to achieve educational and patient safety goals.

Approach: Teaming principles were applied to revitalize the Mayo Clinic IM Residency M&M. All 104 Mayo Clinic postgraduate year (PGY) 2 residents participated in this curriculum in academic years July 2021 to June 2023. Rooted in project management and leadership principles, teaming fosters adaptation and collaboration, making it well suited for analyzing patient safety events (PSEs). A resident-led, faculty-mentored Quality Improvement and Patient Safety (QIPS) Council implemented a teaming-based M&M redesign in July 2021 that included a case selection tool, case vetting by the QIPS Council, and a structured timeline for M&M that ensured effective engagement with multidisciplinary stakeholders. These interventions culminated in a rebranded M&M in which interprofessional institutional leaders (i.e., special guests) were invited to discuss system-wide issues related to the PSE, creating a forum for discussion and identification of improvement opportunities.

Outcomes: Evaluations on the M&M curriculum were completed by 74 of 104 PGY-2 residents (71.2%). Results showed significant improvements before vs after M&M in residents' ability to identify PSEs (57 [77%] vs 69 [93.2%], P = .002), confidence in reporting (50 [67.6%] vs 72 [97.2%], P < .001), analyzing PSEs (44 [59.5%] vs 70 [94.6%], P < .001), and belief that M&M would improve future patient care (58 [78.4%] vs 70 [94.6%], P = .004). Sixty-one residents (82.4%) agreed that participating in M&M would change their future practice.

Next steps: Teaming has transformed the IM residency M&M by fostering effective collaboration among a diverse group of residents and institutional leaders. The next step is to apply the teaming framework to other areas of the residency curriculum where dynamic teamwork is needed.