Educational intervention to improve death certification at a teaching hospital.
BACKGROUND
Information recorded in the 'cause of death' section of death certificates is an important source of mortality statistics. It is used for policy decisions, development of healthcare programmes and health research. Errors in death certificates can lead to inappropriate allocation of resources. Errors are universal and have been reported previously. We planned an educational intervention aimed at resident doctors from various specialties at our teaching hospital to improve the accuracy of the 'cause of death' section in death certificates.


METHODS
Three workshops, each of 90 minutes, were conducted for residents. A total of 198 death certificates (96 before and 102 after intervention) were audited. We compared the frequency of major and minor errors before and after the educational Intervention.


RESULTS
Following the educational intervention, there was a significant decrease in major errors such as unacceptable underlying cause of death (39.6% v. 24.5%, p = 0.034), reporting of mechanism without underlying cause of death (13.5% v. 1%, p = 0.001) and improper sequencing of events (25% v. 6%, p = 0.004). There was no significant decrease in minor errors such as absence of time intervals, use of abbreviations and reporting a mechanism with a legitimate cause.


CONCLUSIONS
Both major and minor errors are common in death certification at teaching hospitals. Educational interventions can improve the accuracy of reporting in death certificates.
Pandya
Himanshu
H
Department of Medicine, H. M. Patel Centre for Medical Care and Education, Karamsad, Gujarat, India. dr_hvp@yahoo.com
Bose
Neeta
N
Shah
Ripal
R
Chaudhury
Nayanjeet
N
Phatak
Ajay
A
D003644:Death Certificates; D006784:Hospitals, Teaching; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency