Background Morbidity and Mortality (M&M) meetings allow outcomes and learning from cases to be shared. The format of how they run is department dependent; our meetings focus on patients transferred out, retrieved to tertiary services and who have sadly died. It was observed that nursing staff often asked about case outcomes but were not present at the M&M meetings when cases were discussed.
Objectives A project was run aiming to:
increase attendance of Multi-Disciplinary Team (MDT) members at meetings
improve dissemination of learning points
Methods Attendance figures were obtained from previous sign-in records and experiences of M&M meetings were captured in a baseline survey.
A Plan, Do, Study, Act approach was followed to achieve the aims, attendance figures and a further survey were used to monitor progression.
Baseline Baseline data showed most attendees were paediatricians (table 1). The initial survey had 17 respondents comprising : 6 Nursing staff, 4 Foundation year (FY) to Specialist trainees 1 – 3 (ST), 3 ST4 and above and 4 Consultants. In total 6 people, (35%) hadn’t been able to attend a meeting, 5 were nursing staff and 1 a ST1-3working in the Paediatric Emergency Department. All 17 respondents wanted the data shared; the most popular suggestions to facilitate this were 9 respondents saying via email or newsletter.
Attendance Interventions to increase attendance included: putting up posters, using word of mouth and emails to advertise meeting dates and times. A small increase in nursing numbers and anaesthetists was observed at meetings following these interventions (table 2).
Learning Points The learning points generated from the meetings were shared in the posters advertising the next session and email invitations.
An interim survey, answered by 15 people (4 nurses, 3 FY1 – ST3, 3 ST4+, 4 Consultants and 1 other) was undertaken prior to the coronavirus pandemic. Respondents self-reported small – medium changes in practice after attendances at meetings and from hearing or seeing about the learning points.
Conclusions Fluctuations in M&M meeting attendances are multifactorial; however, a multi-modal approach to inform people of meetings can increase attendance, beyond just paediatricians. Strategies include re-iterating ‘everyone being welcome’ and making people aware of what the meeting entails. Through increasing attendance this reduces the ‘silo’ nature of M&M meetings thus ensuring learning is shared.
Whilst it was observed that attendees reported a preference to learning at/in the meetings the ongoing pandemic has limited the opportunity for in real life interactions this project has shown that asynchronous learning can still occur from key aspects of the cases.
In addition to continuing to increase MDT attendance interventions include: evaluating the learning experience regarding how other, future cases are managed and actioning the learning points generated.
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