Implementation of multi-disciplinary morbidity, mortality and improvement conferences in oral and maxillofacial surgeon training

在口腔颌面外科医生培训中实施多学科发病率、死亡率和改进会议

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Abstract

This study introduces multi-disciplinary morbidity, mortality and improvement conferences (MD-MM&ICs) to oral and maxillofacial surgery departments and reports the subsequent changes in the incidence of adverse events (AEs). From January 2020 to December 2022, using a reflective learning pathway, MD-MM&ICs were regularly conducted in the form of PPTs of reported cases by young surgeons. The preventive measures, early identification and treatments for AEs were summarized by causally categorizing the key factors for AEs, and postoperative AEs were recorded and classified according to the Clavien-Dindo classification, in order to evaluate the changes in the frequency of AEs and the severity of injuries in the ward after the implementation of MD-MM&ICs. A total of 262 AEs occurred, 68 MD-MM&ICs were conducted, and 122 AEs were reviewed in the meetings. Postoperative hemorrhage/hematoma and wound infection were common complications after oral and maxillofacial surgery, and 60% of surgery-related complications after flap surgery were serious complications (Clavien-Dindo Classification ≥ grade III). Upon the implementation of MD-MM&ICs, the number of AEs decreased year by year, along with serious complications related to the operation from 35.3% to 31.4%. Among them, the incidence of complications after flap surgery showed a trend of decreasing each year. By regularly conducting MD-MM&ICs, the ability of physicians at all levels, especially young physicians, to identify and respond to AEs can be improved. Furthermore, not only can the frequency of AEs be reduced but also the severity of patient injuries, thereby promoting patient medical safety.

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