M&Ms and other Peer Review Conferences in Department of Medicine
The traditional medical Morbidity and Mortality (M&M) conference is undergoing redefinition as the medical quality and safety movement gathers momentum. Moving beyond fingerpointing of an individual who has 'caused' a bad outcome, or serving simply as a caution to others to 'be more vigilant', the new paradigm of M&M conferences brings into consideration analysis of flaws in the care process, and uses 'near-misses' as potentially valuable guides to areas in need of improvement. The M&M conference can also evolve into a hybrid entities, such as the Quality Grand Rounds, or a patient safety-oriented M&M format.
Human factors research considers the teams that actually provide care, helpful and potentially hazardous cognitive patterns, team resilience, and interactions between clinicians and medical technology.
National efforts include publishing by the Agency for Healthcare Research and Quality of on-line M&M cases with general relevance and a closer linkage of the M&M conference to ACGME core competencies. A general approach to sentinel events has been suggested by the University Healthsystem consortium (UHC). The Joint Commission also publishes periodic topic alerts.
Department-Wide Morbidity & Mortality Conferences (Thurs noon-1pm; A700) generally every other month
We are also working to adapt existing quality and complication conferences in individual sections of the department of medicine. The work of these committees is covered under the Illinois Medical Studies Act. A working list of these conferences follows, and further infomation on the work of a given committee can be obtained by contacting the section physician quality contact or administrator (see Leadership). The Institute for Healthcare Improvement has a variety of useful resources, including a useful tool with advice on running more effective QI meetings.
Cardiology
- Catheterization Lab Procedures conference
- Electrophysiology Procedures conference
Dermatology
- Dermatopathology review conference
Emergency Medicine
- EM Peer Review: A weekly review and discussion of an ER case that presents a variety of management issues (including systems-based issues). (Residents and faculty)
- UCAN/EMS Peer Review: Monthly review of UCAN or EMS patient care issues (Residents, faculty and UCAN nursing staff)
- Quarterly Joint EM-Pediatric Trauma Conference
- Monthly Joint EM-Department of Surgery Trauma Conference
- EM-IM QI – a twice monthly meeting that addresses quality and safety issues for ER pts requiring medicine consultation or admission
- Twice monthly multidisciplinary ER QI meeting, with faculty, residents, and nursing leadership
- Twice monthly multidisciplinary "rapid cycle" meeting focused on a variety of operational and clinical issues. (Nurses, ER techs, residents, faculty, APN's, administrators, and personnel from ancillary depts (prn)
Endocrinology
Gastroenterology
- GI procedures complication conference (Chip Dye, MD)
- IBD/Liver Pathology Review
- GI Clinical Review
General Internal Medicine
- Challenging Case Conference (Andy Davis, MD -- 4th Thursday at noon each month)
Geriatrics
- Quarterly Peer Review / Quality Oriented Grand Rounds (Catherine Du Beau, MD)
Hematology Oncology
- Quarterly Chemotherapy Quality Conference - Dec 1, 2008
Hospital Medicine
- Peer Review Quality Conference (every Tues, review cases of: 1) readmission within 30 days; 2) inpatient death; 3) ICU transfer within 24 hour of admission. Chad Whelan, MD)
Infectious Diseases
- Weekly Clinical Conference (HIV genotype/ therapy review) (Weds noon - D Pitrak, MD)
Nephrology
- In-center hemodialysis QA meeting- once a month (chaired by Mary Hammes DO)
- Home dialysis QA meeting- once a month (chaired by Orly Kohn MD)
- Acute dialysis QA meeting – once a month (chaired by Patrick Murray MD)
- Monthly vascular access meeting is in part QA as well (monitoring fistula vs permcaths vs grafts rates)
- Weekly transplant meeting (chaired by Michelle Josephson, MD)
- Bi-monthly transplant meeting, with the transplant surgery in which M&M, deceased donor cases and other quality issues are reviewed
- Monthly clinic QA meeting (chaired by Pradeep Kabambi, MD)
Pulmonary & Critical Care
- Medical Intensive Care -- monthly MICU M&M
Rheumatology
- Grand Rounds / Patient Management Conferences (12-15 times per year)
- Inpatient Service Fellows Pt Management Conference (weekly Weds; Tammy Utset MD)