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Quality improvement on an academic autopsy service
1Department of Pathology, Yale University School of Medicine, New Haven, CT 06520-8023, USA.
Context:
Autopsy rates continue to decline in the United States.
Objective:
Although many of the causes of this decline are external to pathology departments, we hypothesized that intradepartmental efforts to improve the quality of the service we provide to our clinical colleagues could increase our autopsy rate.
Method:
We developed a multifaceted quality improvement program for our autopsy service aimed at increasing the visibility of the service, improving the service's reporting, and increasing the amount and quality of data available from the service.
Setting:
A large academic medical center that performs approximately 250 autopsies each year.
Results:
After implementation of our quality improvement program, the decline in our autopsy rate has not only stopped, but rates have even begun to increase. Additionally, physician satisfaction surveys conducted before and after implementation of our quality improvement initiatives showed an across-the-board improvement in clinician perception of the service.
Conclusion:
Pathologists can and should be proactive in addressing the declining autopsy rate, rather than viewing it as someone else's problem or hoping that someone else will protect this important quality assurance tool for medical care.
