PMID- 36284295
OWN - NLM
STAT- MEDLINE
DCOM- 20221027
LR  - 20221029
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Oct 25
TI  - Cyclic workflow to improve implementation of learning points from morbidity and 
      mortality meetings.
PG  - 1282
LID - 10.1186/s12913-022-08639-2 [doi]
LID - 1282
AB  - BACKGROUND: Morbidity and mortality meetings (M&MMs) are organized in most 
      hospital departments with an educational purpose to learn from adverse events 
      (AEs) to improve patient care. M&MMs often lack effectiveness due to unsuccessful 
      systematic follow-up of areas of improvement. This can have an effect on 
      improving patient safety and care. Therefore, a new strategy that focuses on 
      implementing areas of improvement into daily practice is necessary. The study aim 
      is to see if we could improve the implementation of meeting outcomes from the 
      M&MM by using a cyclic workflow, and which factors are important to achieve its 
      implementation. METHODS: This prospective study took place at the department of 
      gynecologic oncology of a university hospital. Research was conducted with a 
      participatory action research (PAR) approach using 10 consecutive M&MMs in 2019 
      and 2020. The cyclical workflow consisted of an action list based on the 
      PDCA-cycle, a check of the implementation of areas for improvement at the next 
      M&MM and regular monitoring of tasks. Each M&MM was observed and each 
      professional with an assigned task was interviewed and gave their informed 
      consent. Thematic content analysis was performed with the program Atlas.ti 
      8.4.20. RESULTS: Out of the 39 tasks that resulted from 10 M&MMs, 37 (94.8%) 
      followed all the steps in the PDCA-cycle and were implemented. In total, 16 
      interviews were conducted with consultants, nurses, registrars and residents. 
      Five main factors were important to achieve follow-up of areas for improvement: 
      organizational culture, motivation, commitment, communication to mobilize 
      employees and skills. Repetition of the cyclic workflow at the M&MM and an 
      external person who reminded professionals of their assigned task(s) was 
      important to change habits and motivate professionals. CONCLUSION: Cyclical tools 
      can support the implementation of areas for improvement to optimize the M&MM. A 
      M&MM with an organizational culture where attendees can discuss openly and freely 
      may motivate attendees to take on tasks successfully. A positive stimulant to 
      reach commitment of professionals is team participation. Integrating new habits 
      of reflection may lead to a deeper level of learning from the PDCA-cycle and of 
      the M&MM. Creating a learning environment outside of the M&MM may support 
      professionals to take on actions and engage in improvement practices. Future 
      research may focus on including a comparative analysis to show a success rate of 
      the implementation of learning points from the M&MM more clearly.
CI  - (c) 2022. The Author(s).
FAU - Myren, B J
AU  - Myren BJ
AD  - Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands. 
      britt.myren@radboudumc.nl.
FAU - de Hullu, J A
AU  - de Hullu JA
AD  - Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands.
FAU - Koksma, J J
AU  - Koksma JJ
AD  - Health Academy, Radboudumc, Nijmegen, The Netherlands.
FAU - Gelderblom, M E
AU  - Gelderblom ME
AD  - Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands.
FAU - Hermens, R P M G
AU  - Hermens RPMG
AD  - IQ Healthcare, Radboudumc, Nijmegen, The Netherlands.
FAU - Zusterzeel, P L M
AU  - Zusterzeel PLM
AD  - Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20221025
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - Female
MH  - Humans
MH  - Workflow
MH  - Prospective Studies
MH  - *Health Personnel
MH  - *Communication
MH  - Morbidity
PMC - PMC9593980
OTO - NOTNLM
OT  - Complications
OT  - Group meeting
OT  - Healthcare quality
OT  - Learning
OT  - Organizational change
OT  - Patient participation
OT  - Workflow
COIS- The authors declare that they have no competing interests.
EDAT- 2022/10/27 06:00
MHDA- 2022/10/28 06:00
PMCR- 2022/10/25
CRDT- 2022/10/26 00:27
PHST- 2022/02/27 00:00 [received]
PHST- 2022/09/28 00:00 [accepted]
PHST- 2022/09/21 00:00 [revised]
PHST- 2022/10/26 00:27 [entrez]
PHST- 2022/10/27 06:00 [pubmed]
PHST- 2022/10/28 06:00 [medline]
PHST- 2022/10/25 00:00 [pmc-release]
AID - 10.1186/s12913-022-08639-2 [pii]
AID - 8639 [pii]
AID - 10.1186/s12913-022-08639-2 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2022 Oct 25;22(1):1282. doi: 10.1186/s12913-022-08639-2.