Dataset Information

Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study.

ABSTRACT:

Objectives

To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement.

Design

This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare.

Setting

Dutch academic surgical department with a long tradition of M&M.

Participants

An interview sample of surgeons, residents and physician assistants (n=12).

Results

A total of 57 barriers and facilitators to successful M&M, covering 18 themes, varying from 'case type' to 'leadership', were perceived by surgical staff. While some factors related to M&M organisation, others concerned individual or social aspects. Eight factors, of which four were at the social level, had simultaneous positive and negative effects (eg, 'hierarchy' and 'team spirit'). Mediating pathways for M&M success were found to relate to available information, staff motivation and realisation processes.

Conclusions

This study provides leads for improvement of M&M practice, as well as for further research on key elements of successful M&M. Various factors were perceived to affect M&M success, of which many were individual and social rather than organisational factors, affecting information and realisation processes but also staff motivation. Based on these findings, practical recommendations were formulated to guide efforts towards best practices for M&M.

SUBMITTER: de Vos MS

PROVIDER: S-EPMC5695320 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study.

de Vos Marit S MS Hamming Jaap F JF Marang-van de Mheen Perla J PJ

BMJ open 20171112 11

<h4>Objectives</h4>To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement.<h4>Design</h4>This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare.<h4>Setting</h4>Dutch academic surgical department with a long tradition of M&M.<h4>Participants</h4>An interview s ...[more]

PMID: 29133335

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Project description:Background: The poor translation of research findings into routine clinical practice is common in all areas of healthcare. Having a better understanding of how researchers and clinicians experience engagement in and with research, their working relationships and expectations of each other, may be one way to help to facilitate collaborative partnerships and therefore increase successful translation of research into clinical practice.Aims: To explore the views of clinical and research staff about their experiences of working together during research projects and identify the facilitators and barriers.Methods: We conducted four focus groups with 18 participants - clinicians, researchers and those with a dual clinical-research role, recruited from one mental health Trust and one university. Data was analysed using thematic analysis.Results: Eight themes were identified under the headings of two research questions 1) Barriers and facilitators of either engaging in or with research from the perspective of clinical staff, with themes of understanding the benefits of the research; perceived knowledge and personal qualities of researchers; lack of time and organisational support to be involved in and implement research; and lack of feedback about progress and outcome of research. 2) Barriers and facilitators for engaging with clinicians when conducting research, from the perspective of researchers, with themes of understanding what clinicians need to know and how they need to feel to engage with research; demonstrating an understanding of the clinician's world; navigating through the clinical world; and demands of the researcher role.Conclusion: There was agreement between clinicians and researchers about the barriers and facilitators for engaging clinicians in research. Both groups identified that it was the researcher's responsibility to form and maintain good working relationships. Better support for researchers in their role calls for training in communication skills and bespoke training to understand the local context in which research is taking place.

Project description:ObjectiveCommunication failures between clinicians lead to poor patient outcomes. Critically injured patients have multiple injured organ systems and require complex multidisciplinary care from a wide range of healthcare professionals and communication failures are abundantly common. This study sought to determine barriers and facilitators to interdisciplinary communication between the consulting trauma, intensive care unit (ICU) team and specialty consultants for critically injured patients at an urban, safety-net, level 1 trauma centre.DesignAn observational qualitative study of barriers and facilitators to interdisciplinary communication.SettingWe conducted observations of daily rounds in two trauma surgical ICUs and recorded the most frequently consulted teams.ParticipantsKey informant interviews after presenting clinical vignettes as discussion prompts were conducted with a broad range of clinicians from the ICUs and physicians and nurse practitioners from the consultant teams who were identified during the observations. Interviews were recorded and transcribed verbatim. Data of these 10 interviews were combined with primary transcript data from prior study (25 interviews) and analysed together because of the same setting with same themes. Independent coding of the transcripts, with iterative reconciliation, was performed by two coders.Outcomes measuresFacilitators and barriers of interdisciplinary communication were identified.ResultsA total of 35 interview transcripts were analysed. Cardiology and interventional radiology were the most frequently consulted teams. Consulting and consultant clinicians reported that perceived accessibility from the team seeking a consultation and the consultant team impacted interdisciplinary communication. Accessibility had a physical dimension as well as a psychological dimension. Accessibility was demonstrated by responsiveness between clinicians of different disciplines and in turn facilitated interdisciplinary communication. Social norms, cognitive biases, hierarchy and relationships were reported as both facilitators and barriers to accessibility, and therefore, interdisciplinary communication.ConclusionAccessibility impacted interdisciplinary communication between the consulting and the consultant team.Article summaryElucidates barriers and facilitators to interdisciplinary communication between consulting and consultant teams.

Dataset Information

Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study.

Similar Datasets

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