educational value of morbidity and mortality committee in a hospital setting

The Morbidity and Mortality Committee [MMC] review has a great educational value for physicians and medical students. In addition, it has a great impact on health improvement and healthcare delivery. All hospitals in Bahrain should establish an MMC to update their physicians and improve their services. The primary goal of reporting and reviewing morbidities and mortalities is to enhance patients' safety, care and prevent possible sentinel and adverse events. It is expected that hospital morbidities and mortalities would increase as the average human lifespan is increasing. Preventable morbidity or mortality could be due to iatrogenesis, human errors, and negligence. Codman, in the early 1900s, lost his staff privileges at Massachusetts General Hospital in Boston because he initiated Morbidity and Mortality Conferences [MMC]. His effort was resisted by all surgeons for economic reasons. The first recognized MMC was held in 1935. MMC use is now mandated by the Accreditation Council for Graduate Medical Education in human medicine. MMC educational value could be shared through presentation and error/s analysis, dissemination of information. In a teaching hospital, mandatory attendance of MMCs is an essential requirement of training. Members of the MMC should be familiar with Root Cause Analysis; the objective of which is to identify factors that contribute to adverse events. The common goal is to gain insight into causes, describe the adverse event, then ask "why" it happened; continue to ask "why" until the root cause is identified [may take more or less than five "whys"]. It is essential to maintain focus on the process and not the personalities. In many countries and several medical institutions, MMCs have been embedded within the medical curriculum for medical training. Regular hospital morbidity and mortality meetings are educational tools useful for assessing the quality of care and patient safety

rare late presentation of os-odontoideum with severe progressive myelopathy

Os odontoideum is a rare condition, first described in the 19th century. It is an independent ossicle of variable size separated from the hypoplastic dens. It is classified into two anatomic types, dystopic and orthotopic. The condition is commonly seen in males in their second and third decades, and may be found incidentally or manifests as cervical myelopathy. Descriptions of the causes, natural history, optimal management, and surgical interventions are limited and a subject of debate. We report a fifty-seven-year-old female who presented with features of severe progressive cervical myelopathy and severe neck pain, dizziness, and gait imbalance. Imaging revealed os odontoideum with myelomalacia. She underwent C1-C2 closed reduction and posterior fusion using Goel and Harms technique. Symptomatic improvement in terms of pain and balance was observed postoperatively and during follow-up