Improving the autopsy rate at a University Hospital

purpose: Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are measured, there has been a steady decline in the autopsy rate over the last 20 years. At Westchester County Medical Center, a university...

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Published inThe American journal of medicine Vol. 92; no. 4; pp. 423 - 426
Main Authors Clayton, Sherri A., Sivak, Steven L.
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.04.1992
Elsevier
Elsevier Sequoia S.A
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Abstract purpose: Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are measured, there has been a steady decline in the autopsy rate over the last 20 years. At Westchester County Medical Center, a university hospital of New York Medical College, we observed an alarming drop in our autopsy rate. We realized that the methods used to obtain consent from the family of the deceased were haphazard and often left to the junior houseofficer available. We hypothesized that we could increase the autopsy rate by explicitly involving senior housestaff in the task of obtaining autopsy consent after giving them formal instruction in the technique of asking for consent and by having them record information regarding their encounters with families. patients and methods: Data concerning the frequency of autopsies at Westchester County Medical Center were collected for a 3-month period in 1990. A corresponding period in 1991 was designated the study period during which our intervention was initiated. All medical examiner's cases were excluded for both periods since autopsy consent for these patients is not at the discretion of the family. At the start of the study period and each month thereafter, formal instruction regarding obtaining permission for autopsy was given to all senior residents assigned to direct patient care duty. The senior resident was required to complete a data form regarding autopsy request on each patient who died. results: Nine autopsies among 89 deaths (10%) were obtained during the study period in 1990, compared with 31 autopsies among 116 deaths (27%) in 1991 (p <0.01). In 1991, autopsies were more likely to be obtained when death was unexpected (p <0.05). conclusion: The institution of a formal program to educate and involve the senior resident staff in obtaining autopsy consent can significantly improve the autopsy rate at a university hospital.
AbstractList PURPOSEAlthough the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are measured, there has been a steady decline in the autopsy rate over the last 20 years. At Westchester County Medical Center, a university hospital of New York Medical College, we observed an alarming drop in our autopsy rate. We realized that the methods used to obtain consent from the family of the deceased were haphazard and often left to the junior houseofficer available. We hypothesized that we could increase the autopsy rate by explicitly involving senior housestaff in the task of obtaining autopsy consent after giving them formal instruction in the technique of asking for consent and by having them record information regarding their encounters with families.PATIENTS AND METHODSData concerning the frequency of autopsies at Westchester County Medical Center were collected for a 3-month period in 1990. A corresponding period in 1991 was designated the study period during which our intervention was initiated. All medical examiner's cases were excluded for both periods since autopsy consent for these patients is not at the discretion of the family. At the start of the study period and each month thereafter, formal instruction regarding obtaining permission for autopsy was given to all senior residents assigned to direct patient care duty. The senior resident was required to complete a data form regarding autopsy request on each patient who died.RESULTSNine autopsies among 89 deaths (10%) were obtained during the study period in 1990, compared with 31 autopsies among 116 deaths (27%) in 1991 (p less than 0.01). In 1991, autopsies were more likely to be obtained when death was unexpected (p less than 0.05).CONCLUSIONThe institution of a formal program to educate and involve the senior resident staff in obtaining autopsy consent can significantly improve the autopsy rate at a university hospital.
Despite the fact that the autopsy is widely recognized as an invaluable tool for medical education and the standard by which the accuracy of diagnoses are measured, the autopsy rate over the last 20 years has declined. Increasing the autopsy rate at a university hospital was investigated, and it was concluded that the institution of a formal program to educate and involve the senior resident staff in obtaining autopsy consent can improve the rate.
purpose: Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are measured, there has been a steady decline in the autopsy rate over the last 20 years. At Westchester County Medical Center, a university hospital of New York Medical College, we observed an alarming drop in our autopsy rate. We realized that the methods used to obtain consent from the family of the deceased were haphazard and often left to the junior houseofficer available. We hypothesized that we could increase the autopsy rate by explicitly involving senior housestaff in the task of obtaining autopsy consent after giving them formal instruction in the technique of asking for consent and by having them record information regarding their encounters with families. patients and methods: Data concerning the frequency of autopsies at Westchester County Medical Center were collected for a 3-month period in 1990. A corresponding period in 1991 was designated the study period during which our intervention was initiated. All medical examiner's cases were excluded for both periods since autopsy consent for these patients is not at the discretion of the family. At the start of the study period and each month thereafter, formal instruction regarding obtaining permission for autopsy was given to all senior residents assigned to direct patient care duty. The senior resident was required to complete a data form regarding autopsy request on each patient who died. results: Nine autopsies among 89 deaths (10%) were obtained during the study period in 1990, compared with 31 autopsies among 116 deaths (27%) in 1991 (p <0.01). In 1991, autopsies were more likely to be obtained when death was unexpected (p <0.05). conclusion: The institution of a formal program to educate and involve the senior resident staff in obtaining autopsy consent can significantly improve the autopsy rate at a university hospital.
Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are measured, there has been a steady decline in the autopsy rate over the last 20 years. At Westchester County Medical Center, a university hospital of New York Medical College, we observed an alarming drop in our autopsy rate. We realized that the methods used to obtain consent from the family of the deceased were haphazard and often left to the junior houseofficer available. We hypothesized that we could increase the autopsy rate by explicitly involving senior housestaff in the task of obtaining autopsy consent after giving them formal instruction in the technique of asking for consent and by having them record information regarding their encounters with families. Data concerning the frequency of autopsies at Westchester County Medical Center were collected for a 3-month period in 1990. A corresponding period in 1991 was designated the study period during which our intervention was initiated. All medical examiner's cases were excluded for both periods since autopsy consent for these patients is not at the discretion of the family. At the start of the study period and each month thereafter, formal instruction regarding obtaining permission for autopsy was given to all senior residents assigned to direct patient care duty. The senior resident was required to complete a data form regarding autopsy request on each patient who died. Nine autopsies among 89 deaths (10%) were obtained during the study period in 1990, compared with 31 autopsies among 116 deaths (27%) in 1991 (p less than 0.01). In 1991, autopsies were more likely to be obtained when death was unexpected (p less than 0.05). The institution of a formal program to educate and involve the senior resident staff in obtaining autopsy consent can significantly improve the autopsy rate at a university hospital.
Author Sivak, Steven L.
Clayton, Sherri A.
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Cites_doi 10.1093/ajcp/86.2.133
10.1016/0002-9343(89)90305-7
10.1111/j.1365-2362.1988.tb01265.x
10.1016/0002-9343(85)90470-X
10.1056/NEJM197808172990704
10.1056/NEJM198805123181906
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Keywords Human
Teaching hospital
Prevalence
Autopsy
Hospital ward
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Occupational training
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References Schned, Mogielnicki, Stauffer (BIB4) 1986; 86
Landefeld, Chren, Myers, Geller, Robbins, Goldman (BIB5) 1988; 318
Webster, Derman, Kopin, Glassroth, Patterson (BIB7) 1989; 86
Roberts (BIB2) 1978; 299
McPhee, Bottles (BIB1) 1985; 78
Boers (BIB3) 1989; 86
Boers, Nieuwenhuyzen Kruseman, Eulderink, Hermans, Thompson (BIB6) 1988; 18
Smith, Zumwalt (BIB8) 1984; 108
Landefeld (10.1016/0002-9343(92)90273-E_BIB5) 1988; 318
Boers (10.1016/0002-9343(92)90273-E_BIB6) 1988; 18
Roberts (10.1016/0002-9343(92)90273-E_BIB2) 1978; 299
McPhee (10.1016/0002-9343(92)90273-E_BIB1) 1985; 78
Smith (10.1016/0002-9343(92)90273-E_BIB8) 1984; 108
Boers (10.1016/0002-9343(92)90273-E_BIB3) 1989; 86
Webster (10.1016/0002-9343(92)90273-E_BIB7) 1989; 86
Schned (10.1016/0002-9343(92)90273-E_BIB4) 1986; 86
References_xml – volume: 299
  start-page: 332
  year: 1978
  end-page: 338
  ident: BIB2
  article-title: The autopsy: its decline and a suggestion for its revival
  publication-title: N Engl J Med
  contributor:
    fullname: Roberts
– volume: 86
  start-page: 1338
  year: 1986
  ident: BIB4
  article-title: A comprehensive quality assessment program on the autopsy service
  publication-title: Am J Clin Pathol
  contributor:
    fullname: Stauffer
– volume: 18
  start-page: 314
  year: 1988
  end-page: 320
  ident: BIB6
  article-title: Value of autopsy in internal medicine—a one year prospective study of hospital deaths
  publication-title: Eur J Clin Invest
  contributor:
    fullname: Thompson
– volume: 86
  start-page: 325
  year: 1989
  end-page: 326
  ident: BIB7
  article-title: Obtaining permission for an autopsy: its importance for patients and physicians
  publication-title: Am J Med
  contributor:
    fullname: Patterson
– volume: 78
  start-page: 107
  year: 1985
  end-page: 113
  ident: BIB1
  article-title: Autopsy: moribund art or vital science?
  publication-title: Am J Med
  contributor:
    fullname: Bottles
– volume: 86
  start-page: 322
  year: 1989
  end-page: 324
  ident: BIB3
  article-title: The prospects of autopsy: mortui vivos docuerunt?
  publication-title: Have the dead taught the living?
  contributor:
    fullname: Boers
– volume: 108
  start-page: 455
  year: 1984
  end-page: 459
  ident: BIB8
  article-title: One department's experience with increasing the autopsy rate
  publication-title: Arch Pathol Lab Med
  contributor:
    fullname: Zumwalt
– volume: 318
  start-page: 1249
  year: 1988
  end-page: 1254
  ident: BIB5
  article-title: Diagnostic yield of the autopsy in a university hospital and a community hospital
  publication-title: N Engl J Med
  contributor:
    fullname: Goldman
– volume: 86
  start-page: 1338
  year: 1986
  ident: 10.1016/0002-9343(92)90273-E_BIB4
  article-title: A comprehensive quality assessment program on the autopsy service
  publication-title: Am J Clin Pathol
  doi: 10.1093/ajcp/86.2.133
  contributor:
    fullname: Schned
– volume: 108
  start-page: 455
  year: 1984
  ident: 10.1016/0002-9343(92)90273-E_BIB8
  article-title: One department's experience with increasing the autopsy rate
  publication-title: Arch Pathol Lab Med
  contributor:
    fullname: Smith
– volume: 86
  start-page: 325
  year: 1989
  ident: 10.1016/0002-9343(92)90273-E_BIB7
  article-title: Obtaining permission for an autopsy: its importance for patients and physicians
  publication-title: Am J Med
  doi: 10.1016/0002-9343(89)90305-7
  contributor:
    fullname: Webster
– volume: 18
  start-page: 314
  year: 1988
  ident: 10.1016/0002-9343(92)90273-E_BIB6
  article-title: Value of autopsy in internal medicine—a one year prospective study of hospital deaths
  publication-title: Eur J Clin Invest
  doi: 10.1111/j.1365-2362.1988.tb01265.x
  contributor:
    fullname: Boers
– volume: 86
  start-page: 322
  year: 1989
  ident: 10.1016/0002-9343(92)90273-E_BIB3
  article-title: The prospects of autopsy: mortui vivos docuerunt?
  contributor:
    fullname: Boers
– volume: 78
  start-page: 107
  year: 1985
  ident: 10.1016/0002-9343(92)90273-E_BIB1
  article-title: Autopsy: moribund art or vital science?
  publication-title: Am J Med
  doi: 10.1016/0002-9343(85)90470-X
  contributor:
    fullname: McPhee
– volume: 299
  start-page: 332
  year: 1978
  ident: 10.1016/0002-9343(92)90273-E_BIB2
  article-title: The autopsy: its decline and a suggestion for its revival
  publication-title: N Engl J Med
  doi: 10.1056/NEJM197808172990704
  contributor:
    fullname: Roberts
– volume: 318
  start-page: 1249
  year: 1988
  ident: 10.1016/0002-9343(92)90273-E_BIB5
  article-title: Diagnostic yield of the autopsy in a university hospital and a community hospital
  publication-title: N Engl J Med
  doi: 10.1056/NEJM198805123181906
  contributor:
    fullname: Landefeld
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Snippet purpose: Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses...
Although the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses are...
Despite the fact that the autopsy is widely recognized as an invaluable tool for medical education and the standard by which the accuracy of diagnoses are...
PURPOSEAlthough the autopsy is widely recognized as an invaluable tool for medical education, as well as the gold standard by which the accuracy of diagnoses...
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SubjectTerms Autopsies
Autopsy - statistics & numerical data
Biological and medical sciences
Cause of Death
Death, Sudden
Hospitals, University
Humans
Informed Consent
Internship and Residency
Medical research
Medical sciences
Medical Staff, Hospital
New York - epidemiology
Professional-Family Relations
Public health. Hygiene-occupational medicine
Title Improving the autopsy rate at a University Hospital
URI https://dx.doi.org/10.1016/0002-9343(92)90273-E
https://www.ncbi.nlm.nih.gov/pubmed/1558088
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