Beyond rituals: How to optimise M&M meetings into engines of safety and quality improvement in LMICs

Abstract

Morbidity and mortality (M&M) meetings in many low- and middle-income countries (LMICs) remain irregular, rushed, poorly attended and largely symbolic, limiting their potential to drive genuine quality and safety improvement. This paper outlines how M&M meetings can be transformed from ritualistic exercises into structured, psychologically safe platforms for shared learning and system-level change. Effective M&M meetings require regular scheduling, standardised case selection, clear objectives, multidisciplinary participation and a focus on system factors rather than individual blame. Incorporating structured analytical tools, such as root cause analysis, helps identify contributory factors and actionable solutions. Equally essential are formal mechanisms for documenting recommendations, assigning responsibilities and tracking implementation. By embedding principles of transparency, accountability and ‘a just culture’, LMIC health systems will convert M&M meetings into one of the most cost-effective strategies for reducing preventable harm and strengthening patient safety.