Stratification of literature review results into themes, goals, specific interventions and supporting studies
| Theme | Goal | Intervention | Supporting studies |
|---|---|---|---|
| Educational value | Standardized presentations | Time limit < 15–20 min | Abu-Zidan and Premadasa, (11) Kim et al., (29) Murayama et al. (30) |
| Mandatory brief literature review | Abu-Zidan and Premadasa, (11) Kim et al., (29) Mitchell et al., (12) Murayama et al., (30) Risucci et al., (31) Bhalla et al. (32) | ||
| PowerPoint template | Kim et al., (29) Risucci et al. (31) | ||
| SBAR format | Mitchell et al., (12) Mitchell et al. (33) | ||
| Advanced notification of selection to present* | Abu-Zidan and Premadasa, (11) Bhalla et al. (32) | ||
| Matrix format† | Bhalla et al. (32) | ||
| Increased audience interaction | Audience response system | Bhalla et al. (32) | |
| Moderator facilitation of discussion | Clarke et al., (35) Murayama et al., (30) Mitchell et al., (12) Prince et al. (36) | ||
| Targeted questions to specific audience members | Prince et al. (36) | ||
| Enhanced morbidity and mortality continuity | Assigned research for all unanswered questions to be reported at the next MMC | Bhalla et al., (32) Greco et al. (39) | |
| Error analysis | Improved error analysis | Focused analysis on underlying cause of complication | Antonacci et al., (41) Kim et al., (29) Mitchell et al. (12) |
| Taxonomic error analysis‡ | Clarke et al., (35) Cromeens et al. (42) | ||
| Case selection and representation | Comprehensive case selection | Electronic database used to identify cases | Auspitz et al., (19) Cromeens et al, (20) Gurien et al., (17) Hutter et al., (18) Kong and Clarke (34) |
| Moderator selects cases | Bhalla et al. (32) | ||
| Prospective proforma | McVeigh et al. (21) | ||
| Attendance | Improved faculty and resident attendance | Teleconferencing | Falcone and Watson, (38) Lewis et al. (37) |
| Morning meeting time | Murayama et al. (30) | ||
| Dissemination | Established systematic dissemination strategy | Post-MMC newsletter | Bhalla et al. (32) |
| PDCA cycle | Vogel et al. (40) | ||
| Surgeon report cards | Antonacci et al. (41) |
MMC = morbidity and mortality conference; PDCA = plan-do-check-act; SBAR = situation, background, assessment, recommendation.
↵* Advanced notice of selection to present ranged from 2 days (11) to 2–5 weeks (32) and included dissemination of the cases to be presented to prospective MMC attendees to allow time for background research.
↵† Matrix format is a cyclical MMC that involves a designated moderator selecting cases, helping residents with presentations, facilitating discussion, and testing the residents quarterly to create a learning environment that constantly reinforces MMC learning points. (43)
↵‡ Taxonomic error analysis involves categorizing errors to facilitate more specific reporting and analysis of the root cause. Examples of taxonomic categories include domain, impact, type/process, cause, and prevention (35) or more complex determination templates. (42)