Mortality and Morbidity Conference Date

Patient and Procedure Age / Sex Primary Diagnosis Procedure Performed Past Medical / Surgical History Medications Other Pertinent History

Clavien-Dindo Complication Grade Grade V: Mortality Grade IV: End organ failure (e.g. acute kidney injury, MI / CVA / respiratory failure) 4a: single organ failure 4b: MODS Grade IIIB: Re-operation requiring general anesthetic (e.g. take back to OR) Grade IIIA: Intervention not requiring general anesthetic (e.g. IR drain, endoscopy) Grade II: Medical Intervention (e.g. antibiotics, blood transfusion) Grade I: Supportive care only (e.g. IV fluids)

Attribution Table Diagrams Patient Factors Provider Factors System Factors Swiss cheese, or Fish bone

QI: Fishbone diagram

QI: Swiss cheese diagram