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Use of Departmental Morbidity and Mortality Conference as a Real Time Barometer of Outcomes and Quality in Pediatric Appendectomy

Julie A Disano, MD, Mary C Santos, MD, Vamsi V Alli, MD, Morgan K Moroi, BS, Robert E Cilley, MD. Penn State Hershey Medical Center

Introduction: Weekly morbidity and mortality conferences (M&M) are educational staples, playing an important role in quality improvement. After noticing an increased frequency of pediatric appendectomy complications during M&M, we explored the accuracy of this finding.

Methods: M&M listings were reviewed for complications following appendectomy. Data was collected from January 2013 through December 2016 and analyzed in semiannual intervals (CY1: January-June; CY2: July-December). The total number of appendectomies performed was determined from billing data. Complication rates were compared to institutional Pediatric NSQIP data.

Results: 771 appendectomies were performed during the study period with 63 reported complications (8.17%). M&M data indicated an increase in postoperative complications during the CY2-2015 period to 13.58%, from 11.59% in CY1-2015. This was similarly seen in NSQIP data, with a rise in complications from 2.20% to 8.20% between CY1 and CY2 of 2015.

Conclusions: Observed trends in institutional M&M data recognized an increase in reported postoperative complications in CY2-2015, a finding confirmed by pediatric NSQIP data. Using external national benchmarks we validated a cheap and reliable method of QI and outcomes measures based on regularly collected M&M data. Regular review of M&M data provides a cost effective and accurate means of assessing quality in addition to reinforcing the adoption of practice-based learning and systems-based practice. Additionally, this method is a useful barometer for QI at non-NSQIP participating institutions.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94811

Program Number: P008

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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