A cross sectional review of mortality meetings in Gauteng province hospitals in 2014
Date
2016
Authors
Takalani, Azwidihwi Nthangeni
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction
Morbidity and mortality meetings are recognised clinical audit tools with the aim to contribute to improving clinical outcomes. Their role as quality improvement tools, in the South African context, is authenticated by their inclusion into the National Core Standards. The National Core Standards stipulate that monthly morbidity and mortality meetings should be conducted within the various health establishments. Although this standard makes it compulsory for meetings to be held there are no guidelines that outline how meetings should be prepared for and executed.
Aim
The main aim of this study is to assess if meetings are being convened in the various hospital departments in Gauteng Province, 2014 and to determine whether the manner in which meetings are scheduled, prepared for and conducted enable meetings to be used as effective quality improvement tools.
Methods
A cross sectional process review of morbidity and mortality meetings in hospitals in Gauteng province was conducted in 2014. Departments were stratified according to levels of care and a proportional random sample was selected. There were two parts to the study: meeting coordinators from four clinical departments: paediatrics; obstetrics and gynaecology; internal medicine and general surgery completed the administered questionnaire. The respective morbidity and mortality meetings held in each of these departments were then observed.
Results
Twenty three questionnaires were administered and twenty five meetings observed from five districts, three regional, one tertiary and one central hospital. The majority of departments (93%) held meetings. In terms of meeting preparation, 96% of meetings were being coordinated and chaired by the correct people and scheduling of meetings was appropriate. However only 52% of meetings had representative attendance, 27% of cases that were presented were not aligned to meeting objectives and 40% of presentations did not include
sufficient information for insightful discussion. Remedial action plans were not developed in 44% of meetings and up to 57% of those who developed action plans did not follow up on the implementation of these plans. No records of meetings were kept in 48% of departments and 68% of meetings were conducted in the absence of an agenda.
Conclusion
Morbidity and mortality meetings are being held in Gauteng Province however practices are heterogeneous with several indicating that meetings in their current state are not effective quality improvement tools. There is a need for guidelines that inform the purpose, preparation and execution of morbidity and mortality meetings in Gauteng Province to be developed in order to standardise and increase the effectiveness of meetings
Description
A research report submitted to the Faculty of Health Sciences
University of Witwatersrand, Johannesburg, in partial fulfillment of the requirements
for the degree, Master of Medicine in Community Health
December 2016