Elodie Sellier, Sandra David‐Tchouda, Gaëlle Bal and Patrice François
This article aims to analyze morbidity and mortality conferences (M&MCs) in a university‐affiliated hospital, notably their format and progression since the 1990s.
Abstract
Purpose
This article aims to analyze morbidity and mortality conferences (M&MCs) in a university‐affiliated hospital, notably their format and progression since the 1990s.
Design/methodology/approach
A cross‐sectional study was conducted and M&MC characteristics were collected using three methods: a questionnaire to all department heads to identify past M&MCs; semi‐structured interviews with each M&MC leader; and when available, meeting reports were analyzed.
Findings
Of 189 questionnaires sent to department heads, 105 were completed and returned (55.6 per cent). A total of 27 M&MCs were identified; five times more than in 1994. The M&MC format varied greatly between departments. In surgical units, cases per conference tended to be higher than in intensive care or medical units and paramedical staff were invited less often. Compared with 1998, head nurses (70.4 vs 27.3 percent, p=0.03) and paramedical staff (63.0 vs 18.2 percent, p=0.03) attendance increased significantly. Physicians considered M&MCs important for improving service quality, patient safety and enhancing team cohesion.
Research limitations/implications
Patient outcomes were not assessed.
Practical implications
Although undefined formats allowed leaders to conduct M&MCs according to their objectives, how these conferences are conducted should impact healthcare quality and safety.
Originality/value
Results indicate that M&MCs have evolved over the past 20 years, showing them to be valuable quality and safety improvement methods.
Details
Keywords
Van Mô Dang, Patrice François, Pierre Batailler, Arnaud Seigneurin, Jean-Philippe Vittoz, Elodie Sellier and José Labarère
Medical record represents the main information support used by healthcare providers. The purpose of this paper is to examine whether patient perception of hospital care quality…
Abstract
Purpose
Medical record represents the main information support used by healthcare providers. The purpose of this paper is to examine whether patient perception of hospital care quality related to compliance with medical-record keeping.
Design/methodology/approach
The authors merged the original data collected as part of a nationwide audit of medical records with overall and subscale perception scores (range 0-100, with higher scores denoting better rating) computed for 191 respondents to a cross-sectional survey of patients discharged from a university hospital.
Findings
The median overall patient perception score was 77 (25th-75th percentiles, 68-87) and differed according to the presence of discharge summary completed within eight days of discharge (81 v. 75, p=0.03 after adjusting for baseline patient and hospital stay characteristics). No independent associations were found between patient perception scores and the documentation of pain assessment and nutritional disorder screening. Yet, medical record-keeping quality was independently associated with higher patient perception scores for the nurses’ interpersonal and technical skills component.
Research limitations/implications
First, this was a single-center study conducted in a large full-teaching hospital and the findings may not apply to other facilities. Second, the analysis might be underpowered to detect small but clinically significant differences in patient perception scores according to compliance with recording standards. Third, the authors could not investigate whether electronic medical record contributed to better compliance with recording standards and eventually higher patient perception scores.
Practical implications
Because of the potential consequences of poor recording for patient safety, further efforts are warranted to improve the accuracy and completeness of documentation in medical records.
Originality/value
A modest relationship exists between the quality of medical-record keeping and patient perception of hospital care.
Details
Keywords
Pierre Batailler, Patrice François, Van Mô Dang, Elodie Sellier, Jean-Philippe Vittoz, Arnaud Seigneurin and Jose Labarere
– The purpose of this paper is to investigate trends in patient hospital quality perceptions between 1999 and 2010.
Abstract
Purpose
The purpose of this paper is to investigate trends in patient hospital quality perceptions between 1999 and 2010.
Design/methodology/approach
Original data from 11 cross-sectional surveys carried out in a French single university hospital were analyzed. Based on responses to a 29-item survey instrument, overall and subscale perception scores (range 0-10) were computed covering six key hospital care quality dimensions.
Findings
Of 16,516 surveyed patients, 10,704 (64.8 percent) participated in the study. The median overall patient perception score decreased from 7.86 (25th-75th percentiles, 6.67-8.85) in 1999 to 7.82 (25th-75th percentiles, 6.67-8.74) in 2010 (p for trend <0.001). A decreasing trend was observed for the living arrangement subscale score (from 7.78 in 1999 to 7.50 in 2010, p for trend <0.001). Food service and room comfort perceptions deteriorated over the study period while patients increasingly reported better explanations before being examined.
Practical implications
Patient perception scores may disguise divergent judgments on different care aspect while individual items highlight specific areas with room for improvement.
Originality/value
Despite growing pressure on healthcare expenditure, this single-center study showed only modest reduction in patients’ hospital-care perceptions in the 2000s.