To understand Neurology Morbidity and Mortality conference (M&M) practices across US academic medical centers.

While their role has evolved over time, M&M conferences can be used to drive systems improvements that enhance the safety and quality of care. In neurology, little is known about the nature, purpose, or current practice of M&Ms.  We surveyed a sampling of major US academic neurology departments to (1) understand the current role of M&Ms in driving systems improvement and (2) develop a model for best practices.    

An 18-question survey designed to characterize M&M conferences in terms of frequency, structure, content, participants, attendance and outcomes was distributed to 56 academic medical centers via a network of department chairs between April-June 2019.

Survey responses were received from 44 departments (79%).  41 departments (93%) hold M&Ms at least quarterly.  74% of departments restrict discussions to selected adverse events. 95% of departments invite both faculty and trainees, 48% invite nurses, 62% invite medical students, and 38% invite ancillary staff such as therapists.  When compared with other conferences, resident, fellow and faculty attendance is reported as moderate to high by 88% of departments.  Over half of the departments identified conference timing, institutional culture regarding quality and safety, and attendance by department leaders as important factors in improving attendance.  57% employ the just culture algorithm and almost two thirds incorporate root cause analysis (64%).  The majority (69%) reported that, in the last two years, written guidelines or protocols resulted directly from conferences.  M&Ms are used to meet ACGME requirements for residents/fellows in 72% of departments. Only 28% provide risk management CMEs for faculty.  

While many US neurology departments use M&Ms to drive systems improvements, there remains considerable variability across conferences.  There may be opportunities to implement a more standardized agenda to drive improvements in the quality and safety of care.