Surgeon Perceptions and Variations in Surgical Morbidity and Mortality Conference: Report of a Survey from the American College of Surgeons Board of Governors

Abstract

Objective: To highlight the evolution of surgical morbidity and mortality conferences (MMCs) from the early 20^th century as a means of identifying surgeon error into current practices as identifying hospital-based system factors that contribute to adverse patient events. Further, to elucidate differences in the perception of MMCs between trainees and attending surgeons as well as differences in the structure of MMCs geographically and by institution type.

Design: We developed a survey that was distributed to current American College of Surgeon members through Survey Monkey.

Setting: Survey-based study.

Participants: Current members of the American College of Surgeons, including Board of Governors, surgeons, and trainees.

Results: There were a total of 1,396 responses to the survey, 814 (58%) from surgical trainees and 582 (42%) from attending surgeons. Both surgical trainees and attending surgeons noted that the most common day for MMCs was Wednesday and that the most common time for MMCs was before 7:30 AM. Further, most surgical trainees and attending surgeons noted that there was no structured format to their institution's MMCs and that increased attending surgeon engagement would make MMCs more educational. Significant variations in MMCs existed across both geographic region and by institution type.

Conclusion: The results from this survey highlight key aspects of MMCs that contribute to their educational value. Staff engagement was noted to be the most educational aspect of MMCs. While geographic and institutional differences will likely persist, efforts should be made to increase staff engagement at MMCs in addition to a more structured approach.

Keywords: Geographic Variations; Institutional Variations; Morbidity; Mortality; Quality Improvement; Surgical Education.