The Autopsy Process Quality Improvement and Systems Based Practice Melissa Maricondo, DO, MPH June 2, 2009
M&M • Case Based Presentation of the Autopsy Process – January 2009 • Patient expired, family wanted an autopsy, but autopsy did not get done • Break in the system between the housestaff, MIS, medical records, and pathology department
Questions Raised • Whose responsibility is it to see through an autopsy request? • What is Temple University Hospital’s policy regarding autopsy request? – Primary team – Autopsy Service/Department of Pathology and Laboratory Med. – Medical records • The role of the MIS system expiration order, including autopsy request? • How to interpret the Death Certificate wording of autopsy questions? • How long does family have to make autopsy request? • Autopsy process from a pathology perspective?
Interdepartmental Communication • Departments Involved – Pathology – Medical Records – Risk Management – Legal Counsel – Internal Medicine Administration and Housestaff
Follow Up Resident Presentation of Autopsy Process – From Death to Disclosure May 2009
• MIS - “Autopsy pending option” (To get this you first have to answer “yes” to meets autopsy criteria) • Autopsy Process – Pathology perspective – – Does physician have to offer autopsy by law? - No Cost of an autopsy to family? - $0 Does autopsy interfere with funeral? – No Details of procedure outlined to residents • Autopsy Consent Process – Paperwork – What to do if family cannot be reached • Role of Medical Records in closing the loop • Autopsy Report • Disclosure – Whose responsibility – Documentation
Post – Follow up Problems Identified Ongoing Project. . . • When family cannot be reached – not practical for resident/attending to continue searching for family after reasonable time period (48 hours) • Physician entering autopsy order/obtaining autopsy consent is usually resident (not attending) – Important for when physician is covering (NF, PAC) – Important for disclosure • Difficult to keep track of autopsy report when it takes 6 -12 weeks to come back, and doesn’t always make it to resident
Скачать презентацию The Autopsy Process Quality Improvement and Systems Based
5aee77e6c8ac207becf06123126de0ec.ppt