Morbidity and Mortality Conferences in Internal Medicine Specialty Training in Japan: A Nationwide Cross-sectional Study

Ikuo Shimizu; Takashi Watari; Satoshi Watanuki; Takuma Hata

doi:10.2169/internalmedicine.2418-23

Morbidity and Mortality Conferences in Internal Medicine Specialty Training in Japan: A Nationwide Cross-sectional Study

Intern Med. 2023 Oct 6. doi: 10.2169/internalmedicine.2418-23. Online ahead of print.

Authors

Ikuo Shimizu^{1

2}, Takashi Watari³, Satoshi Watanuki^{4

5}, Takuma Hata⁶

Affiliations

¹ Department of Medical Education, Chiba University Graduate School of Medicine, Japan.
² Department of Patient Safety, Chiba University Hospital, Japan.
³ VA Hospital, Division of Hospital Medicine, University of Michigan General Medicine Center, Shimane University Hospital, the United States.
⁴ Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Japan.
⁵ Patient Safety Office, Tokyo Metropolitan Tama Medical Center, Japan.
⁶ Department of General Medicine, Mito Kyodo General Hospital, Japan.

PMID: 37813614
DOI: 10.2169/internalmedicine.2418-23

Abstract

Objective This study evaluated the implementation status of morbidity and mortality conferences in internal medicine specialty training programs in Japan. Methods This cross-sectional study surveyed hospitals in Japan with certified internal medicine specialty training programs. Program directors or equivalently responsible physicians managing certified internal medicine training programs were invited to participate in this study (n=619). Materials Data were collected using an online questionnaire that included questions about the number of morbidity and mortality conferences, types of cases covered, collaboration of the patient safety section and other health professions, and whether or not the conferences were conducted by a subspecialty department-led or program-based. Results Responses were received from 123 hospitals (19.8% response rate), of which 59 (48%) had some form of internal medicine morbidity and mortality conference in place. The average number per year was 9.63 (standard deviation: 18.12). Hospitals with morbidity and mortality conferences in subspecialty departments held significantly more conferences than X (please define X). Furthermore, the involvement of the patient safety department tended to be associated with holding more conferences. Autopsy rates were significantly higher in hospitals with program-based internal medicine morbidity and mortality conferences than subspecialty-led. Conclusion Internal medicine specialty training hospitals had more morbidity and mortality conferences than previously reported. Program-based morbidity and mortality conferences in internal medicine are associated with higher autopsy rates and may lead to an organizational reporting culture and lifelong learning attitudes that support patient safety. Collaboration with organizational management sections, such as patient safety, would be effective in implementing these conferences in internal medicine training programs.

Keywords: internal medicine residency; morbidity and mortality conference; patient safety; quality improvement.