Provider reported challenges with completing death certificates: A focus group study demonstrating potential sources...

Area of Science:

• Medical Informatics
• Public Health
• Oncology

Background:

• Accurate death certification is crucial for public health surveillance and cancer research.
• Challenges exist in documenting the cause of death, particularly for complex cases like cancer.

Purpose of the Study:

• To characterize healthcare provider experiences in completing the cause of death section on death certificates.
• To identify specific challenges related to cancer deaths.

Main Methods:

• Conducted four focus groups with diverse healthcare providers over three months.
• Utilized constant comparison analysis on verbatim transcriptions to identify themes.

Main Results:

• Identified three challenge categories: infrastructural/procedural, clinical uncertainty, and cancer-specific classification.
• Infrastructural issues include rigid forms, lack of training, and no feedback.
• Clinical uncertainty and varied provider perceptions of the death certificate's purpose impact documentation.

Conclusions:

• Significant challenges in death certification lead to errors in cause of death documentation.
• Structural improvements to forms and training mechanisms can address these issues.
• Improving the death certification process enhances data reliability for public health and research.