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Autopsy Service Death Certificate Review.
Alison Krywanczyk1, Elaine Amoresano1, Kanayo Tatsumi2
1Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington (Krywanczyk, Amoresano, Mount).
Archives of Pathology & Laboratory Medicine
|January 28, 2020
Summary
A hospital autopsy service review significantly improved death certificate accuracy, correcting errors like missing causes of death. This process enhances clinician education and ensures reliable public health statistics.
Area of Science:
- Medical Examiner and Coroner Systems
- Public Health
- Pathology
Background:
- Accurate death statistics are crucial for epidemiology and public health.
- Current death certification practices suffer from frequent errors.
- Hospital autopsy services can help rectify these deficiencies.
Purpose of the Study:
- To enhance the accuracy of hospital-issued death certificates.
- To improve medical resident and clinician education on death certification.
- To implement a systematic death certificate review process.
Main Methods:
- Pathology residents reviewed all hospital death certificates daily.
- Certificates were cross-referenced with decedent medical records.
- Amendments were filed electronically, and relevant authorities (Medical Examiner) were notified of discrepancies.
Main Results:
- 15% (88 of 590) of death certificates required amendment over 12 months.
- Common errors included missing underlying cause of death (47%) and contributory causes (47%).
- 26% of amended certificates resulted in a change in the manner of death.
Conclusions:
- Autopsy service review enhances death certificate accuracy.
- The process serves as a vital quality assurance measure for hospitals and state vital statistics.
- This initiative positively impacts clinician education and data integrity.
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