University of California San Francisco

Quality Improvement

QI Procedural Flowchart

Electronic M&M Form

Electronic M&M Instructions 

Practice AreaConditions & ProceduresPrintable Forms
General SurgeryPersistent hyperparathyroidism, Hypocalcemia, Airway obstruction, Anastomotic leak/ stricture, Negative/Nontherapeutic Laparotomy, 
Bowel obstruction, Biliary leakage/stricture, Hepatic insufficiency, Pancreatic fistula, Trocar site injury, Band malposition/ malfunction, Seroma/ hematoma, Other
Bariatric Surgery
Endocrine Surgery
GI Surgery
Oncologic Surgery
Adult CTSternal dehiscence, Stroke, Arrhythmia/ heart block, Esophageal leak, Empyema, Pneumothorax, Bronchopleural fistula, OtherAdult CT
Breast SurgerySkin Necrosis/flap loss, Lymphedema, Seroma, Incomplete Resection, Nerve Injury, OtherBreast Surgery
Colorectal Surgery Anastomotic leak, Pelvic abscess, Ureteral injury, Sexual dysfunction, Urinary dysfunction, Bowel Obstruction, Prolonged illus, OtherColorectal Surgery
Pediatric CTPulmonary hemorrhage, Phrenic nerve palsy, Chylothorax, Low cardiac output syndrome, Endotrachael tube malposition, Stroke/ CNS injury, Paraplegia, OtherPediatric CT 
Pediatric Surgery Error in drug dosage, Perioperative hypothermia, Pneumothorax/ hemothorax, Pre term labor, OtherPediatric Surgery
Plastic SurgeryFlap loss (partial or complete), Graft loss, Exposure of or loss of implantable device, Unacceptable result, Hematoma, OtherPlastic Surgery
Transplant SurgeryLymphocele, Renal/ pancreatic arterial thrombosis, Renal/ portal vein thrombosis, Ureteral leak/ obstruction, Pancreatic/ enteric leak
Biliary leak/ stricture, Hepatic artery thrombosis, Primary non function, Graft loss, Other
Transplant Surgery
Trauma SurgeryFailure to secure or protect airway, Missed injury, Delayed control of hemorrhage, Complication of tube or line placement, Omission of prophylactic interventions, OtherTrauma Surgery
Vascular SurgeryStroke, Graft/ stent/ other thrombosis, Graft infection, Major amputation, Percutaneous access site complication, Spinal cord injury,
Contrast induced nephropathy, Other
Vascular Surgery