ORIGINAL ARTICLE

Death certification: an audit of practice entering the 21st century

B Swift, K West

Department of Histopathology, Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK

Correspondence to:
Correspondence to:
Dr B Swift, Department of Histopathology, Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK

Aims: Death certification, a legal duty of doctors, continues to be poorly performed despite Royal College recommendations and increased education at an undergraduate level. Therefore, the current performance of certifying doctors was audited within a large teaching hospital entering the new century.

Methods: A total of 1000 completed certificate counterfoils were examined retrospectively for appropriateness of completion and the ability to construct a logical cause of death cascade.

Results: Only 55% of certificates were completed to a minimally accepted standard, and many of these failed to provide relevant information to allow adequate ICD-10 coding. Nearly 10% were completed to a poor standard, being illogical or inappropriately completed.

Conclusions: The results show no improvement in the state of certification. Possible interventions to improve outcomes are discussed; however, in light of a recent high profile legal case a current Home Office review of death certification may suggest the passing of statutory law to ensure accurate completion.

Keywords: death; certificate; certification; audit; hospital

Abbreviations: HIV, human immunodeficiency virus; WHO, World Health Organisation

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