Impact of Structured Morbidity and Mortality (M&M) Meetings on Clinician Engagement and Patient Safety Culture.

Abstract

Objectives: To explore the range of experiences and opinions of people participating in morbidity and mortality (M&M) meetings at a public health service, and the perceived effects of a structured approach to the meetings on clinician engagement and patient safety culture.

Methods: Semistructured interviews and focus groups were conducted with 13 participants from a large public health service (14,000 staff) in Australia. A semistructured interview guide was used to explore the experiences and opinions of committee chairs and M&M meeting members. Thematic analysis was used to identify key themes from transcripts.

Results: Five themes were identified: (1) purpose, (2) attendance, (3) formality, (4) case selection and review, and (5) leadership and culture. Within these 5 themes, clear differences emerged in experiences between chairs and members and between individual participants. Factors associated with variation in experiences and opinions of participants included the nature and extent of their individual, previous, and current involvement in M&Ms and with the state of development of their local M&M meeting's purpose, leadership, and governance.

Conclusions: A high level of maturity is required for M&M meetings to meet the diverse and competing needs of clinicians and health services. Structural elements such as a meeting agenda and register of recommended actions may assist junior staff and/or staff who do not attend regularly. Reflective and respectful leaders can foster psychological safety for members. Organisations can support their staff with the administration and communications for M&M meetings and help to share the learnings across departments and hospitals through clinical governance systems.