Wednesday, March 31, 2010

a huge success

Those of you in the medical field will know that M and M rounds (morbidity and mortality) are essential as they provide an opportunity to review unfortunate outcomes; to learn from these and to make improvements in future care. To date there have been no M and M rounds in Rwanda.... until today. We are very proud that this morning we had a combined M and M round with Obstetrics and Gynecology and Anesthesia to review the tragic case we had earlier this month of maternal death from severe pre-eclampsia.

The attendance was excellent. It was standing room only with 45 to 50 people present. All the CHK anesthesiologists attended as well as excellent representation from Obs/Gyne, family medicine and nursing. We understand there was some initial reluctance from Obs/Gyne as they thought this might be a finger pointing session. In fact, it went far better than anyone expected.

One of the OB residents presented a short summary of pre-eclampsia then Ariane presented the case (the same one we used on the web conference). She deserves a lot of credit for presenting in a clear and diplomatic way. The discussion was excellent. Although we didn't agree on all points, it was harmonious and everyone acknowledged the need to try to improve the management of pre-eclampsia and other obstetrical emergencies. Many people expressed the wish to continue to have M and M rounds.

In 2009, CHK managed 2,589 deliveries, almost all of which are high risk as low risk deliveries are managed elsewhere. Of these 6% had full eclampsia.

Both Ariane and I feel a huge sense of accomplishment that these rounds happened at all and were so successful.

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