Time course of postmortem procedures in a palliative care unit

In Japanese hospitals, the processes following recognition of absence of vital signs, including the pronouncement of death, postmortem care, handing over the body to the family or funeral service, and the final postmortem process, often require considerable time. With increasing attention being paid to physician work-hour management and workflow optimization in Japan, these tasks may represent a considerable burden. However, little is known about the actual time course from recognition of absence of vital signs to hospital discharge of the deceased.

We retrospectively reviewed the medical records of the patients who died in our palliative care unit between September 2024 and March 2025. The primary objective was to evaluate the time intervals from pronouncement of death to the initiation of postmortem care, duration of postmortem care, and completion of the postmortem process.

Among the 85 patients discharged after death, time data were available for 81. Pronouncement of death was performed during regular working hours in 17 cases and outside working hours in 64 cases. The median interval from pronouncement of death by the physician to the initiation of postmortem care was 20 min, and the median duration of postmortem care was 40 min. The median time from pronouncement of death by the physician to the postmortem process was 129 min.

These findings provide baseline quantitative data on the workflow burden associated with postmortem procedures in palliative care settings. Future studies should evaluate the operational burden and family-centered outcomes associated with postmortem procedures.