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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Mandatory morbidity and mortality conferences (MMC) at a certified brain tumour centre and certified spine centre – the structured implementation may fulfil the requirements, but what are the consequences of the proposed measures?

Obligatorische Morbiditäts- und Mortalitätskonferenzen (MMK) im zertifizierten Hirntumorzentrum und Wirbelsäulenzentrum der Maximalversorgung – die strukturierte Durchführung genügt der Form, aber welche Maßnahmen folgen daraus?

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  • presenting/speaker Frédéric Ververken - Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier, Deutschland
  • Markus Mehlitz - Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier, Deutschland
  • Andy Ottenbacher - Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier, Deutschland
  • Martin Bettag - Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP115

doi: 10.3205/21dgnc403, urn:nbn:de:0183-21dgnc4031

Published: June 4, 2021

© 2021 Ververken et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: DKG (German Cancer Society, neuro-oncology) or DWG (German Spine Society, spine) certified centres are obligated to carry out a minimum number of annual MMCs. Studies on how they influence healthcare quality and safety in neurosurgery are inconsistent. This study examines MMCs with focus on derived measures, their implementation, relation to quality indicators (QI) and possibilities of improvement.

Methods: Retrospective evaluation of all MMC cases 2014-11/2020 presented at the spine and brain tumour centre of a teaching hospital (severity, derived measures, implementation, possible reasons for non-implementation, relation to QI).

Results: In 34 MMCs, 41 cases (24 brain tumour centre, 17 spine centre) were analysed. The MMCs were further grouped into postoperative complications (66%), operative indications (7%), follow-up care (17%) and diagnostics (10%). In 23 of 41 cases (56%) the MMC topic had a possible influence on public/ non-public quality indicators (Initiative Qualitätmedizin e.V., DKG/Onkozert). 55 proposals for measures derived from the MMCs. At the time of evaluation, 33 of those proposals were implemented (degree of implementation 60%). In 70% of the implemented measures, new guidelines (SOPs) were created or existing ones were adapted. 30% of the implemented measures led to further educational training. 40% of planned measures were not implemented, 16% due to a lack of evidence. The implementation of the other measures (24%) was not precisely defined or followed up.

Conclusion: In addition to an educational aspect, MMCs have a high potential to identify improvement measures in patient care. In this analysis, we observed that the implementation of some measures had to be postponed due to a lack of evidence. Conversely, MMCs could be used as a tool to identify significant scientific questions. A major number of analysed cases and measures were related to quality indicators (QI). Therefore, a higher degree of implementation of measures should be achieved (e.g. via Plan-Do-Check-Act cycle). Prospective studies could be useful to investigate the effect of MMCs on established QI.