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Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Assessment of errors in death certification and mortality patterns and trends among medical patients at Korle Bu
Francis Agyekum1,2, Isabella E Asamoah1,2, Muhyideen Bashir2
1Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra.
Insights
Medical Certification of Cause of Death (MCCD) forms at Korle-Bu Teaching Hospital had a 98% error rate, primarily in reporting the underlying cause of death. Non-communicable diseases were the leading cause of mortality.
Area of Science:
- Medical certification of death
- Public health surveillance
- Mortality data analysis
Background:
- Accurate death certification is crucial for public health statistics and disease surveillance.
- The Medical Certification of Cause of Death (MCCD) form is a key document for recording mortality data.
- Previous assessments of MCCD accuracy in similar settings have indicated potential challenges.
Purpose of the Study:
- To audit the accuracy, completeness, and consistency of Medical Certification of Cause of Death (MCCD) forms.
- To analyze trends in mortality causes at Korle-Bu Teaching Hospital.
- To identify common errors in death certification to inform targeted interventions.
Main Methods:
- Retrospective review of completed MCCD forms.
- Audit of 4,544 MCCD forms issued between January 1, 2019, and December 31, 2023.
- Analysis of error frequencies (major and minor) and leading causes of death.
Main Results:
- A high error rate of 98.17% was found in MCCD forms.
- Major errors, particularly incorrect reporting of the underlying cause of death (76.65%), were prevalent.
- Minor errors, such as incomplete addresses (99.69%), were nearly universal.
- Non-communicable diseases (NCDs) accounted for over half of the recorded deaths annually, with cardiovascular conditions being the leading cause.
Conclusions:
- There is a critical need for improved accuracy in death certification through regular healthcare professional training.
- The significant burden of NCD-related deaths necessitates strategies to address modifiable risk factors and strengthen health systems.
- Multisectoral collaboration is essential to combat the growing NCD epidemic.
Objectives:
This study audited the Medical Certification of Cause of Death (MCCD) forms issued at Korle-Bu Teaching Hospital, assessing their accuracy, completeness, and consistency while analysing trends in mortality causes.
Design:
Retrospective review of completed MCCD forms.
Setting:
Korle-Bu Teaching Hospital, Department of Medicine.
Participants:
All duplicate MCCD forms issued between January 1st, 2019, and December 31st, 2023, were included.
Interventions:
No intervention.
Main Outcome Measures:
Frequency of major and minor errors in completing the MCCD forms and leading causes of death in the department.
Results:
Of 4,544 MCCD forms audited, 4,460 (98.17%) contained errors. Major errors were observed in 4,028 (88.64%) forms; the commonest being incorrect reporting of the underlying cause of death (3,483; 76.65%). Minor errors were nearly universal (99.82%), with omission of the full address of the deceased (4,530; 99.69%) being most frequent. Over half of the recorded deaths each year were attributable to non-communicable diseases (NCDs), with cardiovascular-related conditions being the leading cause of death.
Conclusions:
There was a high prevalence of errors in MCCD forms, highlighting the need for regular training of healthcare professionals to improve accuracy in death certification. Additionally, the high burden of NCD-related deaths emphasises the need to address modifiable risk factors, strengthen health systems, and foster multisectoral collaboration to mitigate the growing NCD epidemic.
Funding:
None declared.
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