Morbidity and Mortality Conference Can Reduce Avoidable Morbidity in Neurosurgery: Its Educational Effect on Residents and Surgical Safety Outcomes

BACKGROUND: Morbidity and mortality conferences (MMCs) are now widely implemented in clinical hospitals, but their impact on the education for neurosurgeons remains limited. This prospective study was aimed to assess the efficacy and benefit of MMCs on the education for neurosurgeon. METHODS: All morbidity and mortality events were prospectively recorded and were categorized on the basis of 2 viewpoints. First, they were classified into avoidable and unavoidable events, based on the quality of each event. Simultaneously, they were classified into 3 groups, including the residents, attendant members, or unclassifiable, based on the experience of the neurosurgeon who were most closely related to each event. The information was compared between early (2013-2014) and late (2015-2017) study periods to evaluate the education value of MMCs. RESULTS: During a 5-year study period, 44 mortality (2.1% per patient) and 201 morbidity events (9.7% per patient) were recorded. There were no significant differences in the incidence of mortality between 2 periods (P = 0.52). The incidence of morbidity significantly decreased from 11.5% (83/723) to 8.4% (118/1403; P < 0.04). Of these, avoidable events, but not unavoidable events significantly decreased from 7.5% (54/723) to 4.2% (59/1403; P = 0.001). The decrease in the incidence of avoidable morbidity was more pronounced in the residents than in the attendant members (P = 0.007 and P = 0.04, respectively). CONCLUSIONS: Knowledge acquisition from MMCs can significantly reduce avoidable morbidity events in both residents and experienced neurosurgeons. The educational effect was more distinct in the residents.