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Analyse et impact des revues de morbimortalité (RMM) au sein d’un pôle de médecine d’urgence

Analysis of morbidity and mortality conferences in an emergency department

  • Article Original / Original Article
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Annales françaises de médecine d'urgence

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Résumé

Introduction

Une revue de morbimortalité (RMM) a pour objectif l’analyse collective rétrospective de cas anonymisés marqués par la survenue d’un décès ou d’une complication, afin d’améliorer la qualité des soins. Notre objectif est de décrire et d’analyser les principaux dysfonctionnements et propositions correctrices résultant de l’analyse des dossiers en RMM au sein d’un pôle de médecine d’urgence.

Matériel et méthodes

Analyse rétrospective des dossiers de RMM de deux services d’urgences adultes et d’un Samu sur un an. Chaque dossier est classé en fonction des problèmes rencontrés et des propositions correctrices proposées.

Résultats

Dix-huit RMM ont été réalisées: huit aux urgences, neuf au Samu et une en réunion commune dite de pôle. Cinquante-cinq dossiers ont été analysés avec une présence moyenne de 22 participants par réunion. Les thèmes abordés le plus fréquemment sont la traumatologie pour les services d’urgences et la cardiologie pour le Samu. Quarante pour cent des dossiers (n = 27) sont consécutifs à des problèmes diagnostiques, 15 dossiers (22 %) objectivent des choix stratégiques erronés et des problèmes de communication sont présents dans neuf dossiers. Tous les dossiers ont abouti à des propositions correctrices: formations, élaborations de procédures ou filières de soins.

Conclusion

Les RMM au sein de notre pôle permettent de dégager de nombreuses propositions correctrices devant aboutir à l’amélioration des soins d’urgence de nos patients. Notre étude met aussi en avant l’intérêt des RMM de pôle permettant l’analyse complète du circuit patient depuis l’appel au Samu jusqu’à l’hospitalisation dans un service d’urgences.

Abstract

Aims

A review of morbidity and mortality (RMM) aims to analyze retrospectively and collectively anonymized cases marked by the occurrence of death or complications, and to improve the quality of care. Our objective was to describe and analyze the main dysfunctions and remedial proposals resulting from the analysis of RMM records within a center of emergency medicine.

Procedure

Retrospective analysis of RMM cases of two adult emergency departments and one emergency medical service (Samu) over a year was conducted. Each case was classified according to the encountered problems and proposed remedial recommendations.

Results

Eighteen RMMs were performed: eight in emergency departments, nine in Samu and one in joint meeting called center meeting. Fifty-five cases were analyzed with an average attendance of 22 participants per meeting. The most frequent theme was trauma for emergency departments and cardiology for Samu. Forty percent of cases (N = 27) were consecutive to diagnostic problems; 15 cases (22%) showed a wrong strategic choices; communication problems were present in 9 cases. All records have resulted in remedial proposals: trainings, development of procedures or courses of care.

Conclusion

The RMM within our center led to numerous remedial proposals ending up to the improvement of emergency care for our patients. Our study also highlights the interest of RMM within a center for the complete analysis of the patient circuit from the call to the ambulance to admission in an emergency department.

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Authors and Affiliations

  1. CHU de Toulouse Purpan, Samu 31, F-31059, Toulouse cedex 9, France

    B. Vallé, E. Dehours & J. -L. Ducassé

  2. Service des urgences adultes, CHU de Toulouse Rangueil, Toulouse, France

    J. Mallet, R. Aniba, H. Juchet & D. Lauque

  3. Service des urgences adultes, CHU de Toulouse Purpan, Toulouse, France

    M. Belhadj & D. Lauque

  4. Université Paul-Sabatier, Toulouse-III, Toulouse, France

    D. Lauque

  5. Inserm UMR 1027, service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, université de Toulouse, Toulouse, France

    V. Bounes

Authors
  1. B. Vallé
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  2. E. Dehours
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  3. J. Mallet
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  4. M. Belhadj
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  5. R. Aniba
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  6. H. Juchet
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  7. V. Bounes
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  8. J. -L. Ducassé
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  9. D. Lauque
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Corresponding author

Correspondence to B. Vallé.

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Vallé, B., Dehours, E., Mallet, J. et al. Analyse et impact des revues de morbimortalité (RMM) au sein d’un pôle de médecine d’urgence. Ann. Fr. Med. Urgence 2, 365–371 (2012). https://doi.org/10.1007/s13341-012-0207-8

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  • DOI: https://doi.org/10.1007/s13341-012-0207-8

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