High autopsy rates at a university medical center. What has gone right?
OBJECTIVE
Identification of factors that contribute to a high autopsy rate at our institution.


METHODS
An objective analysis of the Autopsy Service's organization, functions, and process flow to identify factors that impact the autopsy rate.


METHODS
The University of Texas Medical Branch at Galveston, Tex.


METHODS
Statistics were collected using the autopsy log book and computerized data bank. The events starting at the time of a patient's death through the completion of the autopsy report were reviewed. The role of each significant event was analyzed.


CONCLUSIONS
The annual autopsy rates between 1981 and 1995 ranged between 45% and 59%. The largest number of nonmedicolegal autopsies were received from the Department of Internal Medicine. The Texas Department of Criminal Justice Hospital contributed the largest number of medicolegal autopsies. We conclude that the following key factors contribute to our high autopsy rates: (1) the organization and multiple functions of the Autopsy Service, particularly the presence of a Decedent Affairs Office, dedicated resident assignments, and internal and external quality control of the autopsies; (2) close interactions with clinicians, including timely communication of autopsy results to clinicians and a fostering of positive attitude among clinical residents and faculty; and (3) other factors such as the contributions to hospital risk management, disproving the idea that there may be increased litigation related to high autopsy rates, and support by the hospital administration.
Haque
A K
AK
University of Texas Medical Branch, Department of Pathology, Galveston 77550-0743, USA.
Patterson
R C
RC
Grafe
M R
MR
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D001344:Autopsy / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data*; D005554:Forensic Medicine; D006801:Humans; D008329:Managed Care Programs; D010337:Pathology Department, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D010820:Physicians; D011786:Quality Control; D013781:Texas