Standardization of Non-academic Center Surgical Morbidity and Mortality Conference: a Type I Hybrid Implementation Non-clinical Trial.

Surgery, Surgery--Complications

Morbidity and mortality conference, Quality Improvement, Implementation Science

* Specific Aim 1: Determine impact of standardized morbidity and mortality (M&M) toolkit on provider satisfaction with, and perceived impact of, M&M conference. * Specific Aim 2: Identify barriers and facilitators to toolkit implementation.

Design: \- Pre-, post- intervention mixed-methods trial. * Inclusion: o M&M conference attendees at enrolled level II and III trauma centers, inclusive of trainees, administrative staff, providers. * Exclusion: * Age \< 18 * Anticipated attendance at \<= one M&M conference at study site. * Intervention: * Brief didactic regarding evidence base for M&M conferences. * Sequential deployment of standardized M&M toolkit * Standardized slide deck * Code of conduct * Conference planning checklist * Case documentation form * Recruitment: o Pre/post survey: * M&M attendees will be invited to scan a QR code made available at the beginning of an M&M conference, and to take 5 minutes to fill the associated survey if they consent. o Semi-structured interview: * The research coordinator contact information will be emailed to M&M listserv, requesting interested parties contact them to schedule an interview. * Data collection o Specific Aim 1: * Pre/post 10 question digital, anonymous mixed-methods (one free text question) survey • Demographics collected: occupation (surgeon / app / non-surgeon physician / other), years in practice (\<10, 10-20, \>20) * Observation of M&M to capture: • # of attendees * \# of cases presented at each conference * \# of cases which include literature review * \# of cases which include determination of recommended system change (just culture..?) * Specific Aim 2: * Three, six and nine months after initial toolkit deployment we will conduct semi-structured interviews regarding implementation barriers and facilitators. * Interviews will be conducted in-person and audio-recorded. * Interview guide will be modified to emphasize opportunities for improvement identified in initial quantitative data collection. * For instance, if baseline data suggests case referral is the primary problem, will triage discussion of this portion of the M&M process higher and ask additional detail regarding perceived means of improvement. * The interview guide scope will not change from that submitted, the emphasis will pivot as described. * Data analysis will be ongoing, and results of each interview set will be used to inform adaptation of implementation approach. * Consent o Would like to submit a request for waiver of written consent and inclusion of information sheet in survey with confirmation of understanding but without signature, collection of names. * Timeline o Baseline survey and observational data collection Feb - April 2022, intervention deployment March - May 2022, follow-up data collection Feb - April 2023. * Study Sites o Northern Colorado M&M (Greeley, Longs Peak, Poudre Valley, Medical Center of the Rockies)

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United States