Enhancing autopsy performance and reporting. A system for a 5-day completion time.
OBJECTIVE
To develop a system for enhancing the performance and reporting of autopsies in an effective and clinically useful manner.


METHODS
Twelve steps were defined as essential for the completion of the autopsy. Each step of the process was evaluated for usefulness and effectiveness.


METHODS
Autopsies performed in a university hospital from 1992 through 1994.


METHODS
Pathology residents and staff, clinicians, and clinical team house staff.


METHODS
Participants followed the 12-step process, with emphasis on involving the clinical team in the interview, prosection, and final rounds. The final rounds conference was designated a working conference, where the perfused-fixed brain was cut, histologic sections of the case were submitted, and the provisional diagnosis was written with the clinicians. A next-day microscopic slide review session was scheduled to "sign out" the case. Establishing a philosophy of status equal to all other department functions facilitated implementation.


METHODS
All autopsies performed for a period of 3 years (2 retrospective and 1 prospective) were included.


RESULTS
The autopsy completion time was reduced from a mean of 57 days (range 7 to 174) in 1992 to 4.8 days (range 1 to 16) in 1994.


CONCLUSIONS
The autopsy completion time was reduced, increasing its usefulness for teaching and quality assurance. Relationships with the clinical staff were enhanced with consultation-style final reports. Enthusiasm for, and satisfaction with, the new process was expressed by clinicians, pathology staff, residents, and technical support staff.
Adickes
E D
ED
Department of Pathology, St Joseph Hospital, Creighton University School of Medicine, Omaha, Nebraska, USA.
Sims
K L
KL
D001344:Autopsy / Q000592:standards*; D006801:Humans; D007396:Internship and Residency; D008499:Medical Records / Q000592:standards*; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors