Stanford Multidisciplinary Quality Rounds Improves Patient Care Through Collaborative Video-Based Review
January 27, 2026
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Early one Monday morning, before the sun had cracked the horizon, the assembly room at Stanford Hospital was packed with people wearing blue from head to toe. Scrub blue.
Welcome Stanford Multidisciplinary Quality Rounds (MDQ). The meeting, held quarterly, regularly attracts more than 400 participants both in person and online from the Department of Anesthesiology, the Department of Surgery, and the Interventional Platform.
Tara Lahiji-Neary, Senior Quality Consultant at SHC, explained, “MDQs are somewhat similar to Morbidity and Mortality conferences, but the emphasis is on broader themes rather than specific patient details. We select one or more cases and use Black Box footage to identify process-related improvement opportunities, focusing on systems rather than individuals.”
The Black Box (BB) was installed in Stanford operating rooms in 2022. Modeled after aviation technology, the BB records all activity in the room from conversations to vital signs and machine malfunctions. It is then deidentified before review.
Dr. Joe Forrester, Associate Vice Chair of Quality Improvement at Stanford Surgery, said having the technology was a catalyst for starting MDQ.
“We had identified the need to improve the culture of safety on the interventional platform and now we had the technology to support this transformation in a tangible fashion,” said Forrester.
Each MDQ begins with learning objectives and includes a case review. There’s then a facilitated discussion. Leadership emphasized that BB footage was non-punitive and that the purpose of review was to improve patient safety.
At the January MDQ, the group reviewed a case where an equipment malfunction during transport from the ICU to the OR put the patient's health at risk. A panel of specialists analyzed the event, answered questions, and took comments from attendees.
They also unveiled a new initiative: No One Travels Alone (NOTA) which aims to provide “patient-centric, safe transport” to the OR from anywhere in the hospital. A pilot study is underway in the ICU.
Actionable items have been identified and interventions have been implemented ay each MDQ. An MDQ in August 2024, led to an “OR Hemorrhage Alert," which went live January 7, 2026. Similarly, a January and April MDQ in 2025, led to the Surgical & Procedural Safety Policy being published in December 2025. Initiatives from more recent MDQs are still in progress.
“[MDQ] turns a ‘near miss’ into an educational opportunity,” said Dr. Teodore Grantcharov, a Professor of Surgery and inventor of the BB. “This has inspired me to do a better job next time I’m in the OR.”
Want to start your own BDQ? A guide detailing the format and tips for success by Forrester et al, can be found here.
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