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Published in: World Journal of Surgery 11/2018

Open Access 01-11-2018 | Original Scientific Report

Electronic Voting to Improve Morbidity and Mortality Conferences

Authors: Joel Zindel, Reto M. Kaderli, Manuel O. Jakob, Michel Dosch, Franziska Tschan, Daniel Candinas, Guido Beldi

Published in: World Journal of Surgery | Issue 11/2018

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Abstract

Background

It is of major importance in clinical surgery to identify potential patterns and specific causes of complications. Therefore, morbidity and mortality meetings (M&M) are widely used to discuss and evaluate deviations from expected outcomes in order to improve surgical practice. Moreover, M&M represent an important tool for continuous medical education. In this study, we introduced an electronic voting system to assess whether anonymity during M&M could limit potential biases due to hierarchical structures or opinion leaders.

Methods

This study was conducted in the surgical department of a European tertiary care center. During the study period, electronic voting was applied in 412 M&M cases and compared with a baseline of 330 conventional M&M entries. In this interrupted time series, the educational quality and participant satisfaction of the M&M were assessed using surveys before and after the introduction of electronic voting. The surveys were refined using principle component analysis. In addition, the classification of the cause of the complication was recorded.

Results

The introduction of electronic voting led to a significant increase in perceived educational quality from 2.63 to 3.36 (p < 0.01), and the overall participant satisfaction increased from 2.6 ± 0.9 to 3.7 ± 1.2 (p < 0.01) on a five-point Likert scale. The frequency of voting shifted from “patient’s disease” (before 42.9, after 27.6%, p = 0.04) to “misadventure” (before 1.1, after 16.0%, p < 0.01). The voting frequencies for the causes attributed to “management” and “technical” remained constant.

Conclusions

An electronic voting system in M&M meetings increases perceived educational quality and participant satisfaction.
Appendix
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Metadata
Title
Electronic Voting to Improve Morbidity and Mortality Conferences
Authors
Joel Zindel
Reto M. Kaderli
Manuel O. Jakob
Michel Dosch
Franziska Tschan
Daniel Candinas
Guido Beldi
Publication date
01-11-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4670-2

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