Abstract
Background
Patient participation in healthcare is seen as a way of improving the quality of healthcare. Inviting patients to join the discussion about an adverse event at their own Morbidity and Mortality meeting (M&MM) is an innovative way to improve the often criticised meeting and provide patient-centred care. The department of gynaecological oncology of a tertiary hospital in the Netherlands started inviting patients to their M&MM. They evaluated which practical constraints and experiences from the perspective of patients’ and their healthcare professionals’ were important and whether and how they can learn from adverse events.
Methods
Explorative qualitative research was performed with semi-structured interviews including patients and professionals who attended M&MMs in the period of 2016 – 2018. Two interview guides were developed, focusing on their experiences and practical elements of the meeting. Every interview participant signed an informed consent prior to the start of the interview. The interviews were transcribed, coded and analysed by thematic content analysis with the program Atlas.ti. This analyses process started with open coding of the transcripts and lead to a coding tree.
Results
Eight patients and seventeen healthcare professionals (nurses, registrars, consultants) participated in the study. The most significant themes in the domain of interpersonal dynamics, were trust and safety for patients; notions of quality for healthcare professionals; the patient-doctor relationship, language, openness of communication, learning and personal impact for both patients and healthcare professionals. All participants suggested to maintain the current practical design of the meeting, especially the support from the case manager prior, during and after the meeting and to keep inviting all involved healthcare professionals.
Conclusion Both patients and healthcare professionals valued the M&MM with patient participation. Its new design can be organised in a safe environment when conditions such as a stable patient-doctor relationship are adhered. It also provided more opportunities to learn from the meeting in which healthcare professionals felt more comfortable over time.
Current research to further improve the M&MM with patient participation focuses on how learning points from the meeting can lead to clinical practice change. In addition, research in different hospital departments is currently conducted to inform general guidelines for patient participation at the M&MM that are applicable in different contexts.

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