Rapid Responses to:

EDITORIALS: Nancy N Baxter Monitoring surgical mortality BMJ 2005; 330: 1098-1099 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

monthly mortality/morbidity meetings

Pantula SRK Sastry   (13 May 2005)

Re: monthly mortality/morbidity meetings

Roy Jogiya   (15 May 2005)

Length of Stay and Readmissions

Benny Van Bruwaene, Jan Schots   (7 September 2005)

monthly mortality/morbidity meetings 13 May 2005
Pantula SRK Sastry, Asst Prof & Medical Oncologist & BMT physician Tata Memorial Hospital, Parel, Mumbai , India.PIN code; 400012 Send response to journal: Re: monthly mortality/morbidity meetings	Sir, At our institution we have a monthly mortality/morbidity meeting where such cases are discussed in an open forum. This often results in improvements both at administrative, managerial level as well as improvements in patient management. Every tertiary level hospital should follow this practice. Competing interests: None declared
Re: monthly mortality/morbidity meetings 15 May 2005
Roy Jogiya, PRHO in general Surgery West Middlesex Hospital Send response to journal: Re: Re: monthly mortality/morbidity meetings	I too am in agreement with the article and the response. However, I would like to extend this statement. The monthly morbidity and mortality (more commonly known as the M&M meetings) audits should not only be routinely carried out by tertiary referal units but by every hospital with a surgical department. Clinical audit allows the review of clinical performance; it translates to improved quality of clinical healthcare. So, ultimately as clinicans, surely this ought to be our aim? Competing interests: None declared
Length of Stay and Readmissions 7 September 2005
Benny Van Bruwaene, staff member University Hospital AZ VUB, 1090 Brussels, Belgium, Jan Schots Send response to journal: Re: Length of Stay and Readmissions	In our hospital we found a reduction of unplanned readmissions after valve surgery from 21 % to 12 % between 2001 and 2003 although the length of stay was shortened from 12 to 8 days. The result was probably due to the increased experience of the medical staff. On the other hand, shortening the length of stay for heart failure from 12 to 8 days increased the number of readmissions from 6 % to 15 % (p=0,1). This could be due to the fact that the length of stay was reduced for administrative reasons below a certain threshold. We believe the effect of length of stay on readmissions should be evaluated with control for case mix and hospital department. This could be done by a correlation between the evolution of the average length of stay and readmissions over the years within the same hospital department. However, a significant correlation might start only below a certain threshold. Competing interests: None declared