Morbidity and mortality conferences can improve safety

Morbidity and mortality conferences (MMC) are a staple in anesthesia and surgery, but rare in dermatology. That difference is dermatology’s loss, said Alice J. Watson, MD, MPH, a dermatologist at Brigham and Women’s Hospital and assistant professor at Harvard Medical School.

Alice J. Watson, MD, MPH

“Morbidity and mortality conferences can be a powerful tool to drive safety and quality in your practice. We are not perfect, and the systems we work in are not perfect,” Dr. Watson said. “We all make mistakes, take shortcuts, and get distracted. There is plenty to work with even if dermatology doesn’t have a lot of mortality.”

Dr. Watson discussed the theory and practice of MMC during Saturday’s “The Revamped Morbidity and Mortality Conference — A Must for All Dermatology Practices” (U035).

She organizes a quarterly dermatology MMC at lunchtime for providers and a breakfast MMC for other staff every six months. Any event that includes food attracts more attendees, she noted, and increased attendance increases attention and impact.

Near misses are more common than lapses that affect patients and are no less important for lack of immediate patient harm.

“When you reduce near misses, you dramatically reduce the incidence of events that result in harm,” she said. “The more you focus on safety, the more attention people pay to safety. And it is easier to talk about a near miss than the time someone lost a biopsy specimen or misdiagnosed a cancer.”

Regular attention to safety pays off, Dr. Watson added. After more than two years of MMC, Brigham faculty surveys show the percentage of providers from whom they get feedback increased from 7% to 29%. The percentage of providers who believe mistakes will not be held against them jumped from 13% to 60%.

“It doesn’t have to be a disaster to be a useful MMC discussion,” she said. “Safety is about the things that happen every day. It is about raising awareness of safety issues in everything we do.”