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Death Notification: Someone Needs To Call the Family
Rachel Ombres1, Lauren Montemorano2, Daniel Becker3
11 Hospice and Palliative Medicine Fellow, National Institutes of Health , Bethesda, Maryland.
Journal of Palliative Medicine
|January 19, 2017
Summary
Most internal medicine residents feel unprepared for death notification calls, highlighting a need for standardized training. This study reveals significant gaps in current practices and emphasizes the importance of improving physician communication skills during this sensitive process.
Area of Science:
- Medical Education
- Physician Communication
- Grief and Bereavement Studies
Background:
- The process of notifying families of a patient's death significantly impacts family grief and physician well-being.
- Currently, there is no standardized protocol for making death notification phone calls, leading to potential unpreparedness and distress for residents.
- Existing practices may not adequately support grieving families or the physicians involved.
Purpose of the Study:
- To investigate current death notification practices among internal medicine residents.
- To develop an evidence-based template for standardizing the death notification process.
- To identify areas for improved resident training and support.
Main Methods:
- A literature review and open-ended interviews with faculty, residents, and widows were conducted.
- A survey was developed based on literature review and interview findings to assess resident training and experience in phone-based death notification.
- The survey was administered to all internal medicine residents at the institution.
Main Results:
- Seventy-two percent of internal medicine residents (67/93) responded to the survey, with 87% reporting involvement in phone-based death notifications.
- A significant majority (80%) of residents felt inadequately trained for this task, and over 25% reported poorly executed calls.
- Practices lacked consistency in preparation, delivery, family support during travel and arrival, and post-call follow-up, with limited involvement from attending physicians, nurses, or chaplains.
Conclusions:
- Inadequate communication during death notifications can exacerbate complicated grief in families and increase physician stress.
- This study provides the first description of current death notification practices by internal medicine residents.
- Enhanced training, potentially integrated with medical error disclosure education, is crucial to improve death notification protocols and outcomes.