Addressing Death Certificate Errors through Education

The cause-of-death (COD) on death certificates (DCs) impacts epidemiology, research, public health interventions, insurance payout, and justice. Despite the availability of national resources, most physicians have not received formal training regarding DCs, resulting in errors. We completed a retrospective sampling of DCs from a single institution between 1/1/2019 and 12/31/2019 to evaluate the frequency and types of errors in COD reporting. Cases were excluded if final DCs could not be obtained or if the decedent\u27s medical record had a limited history. COD reporting errors were categorized as minor and major. Minor errors did not affect the interpretation of COD, while major errors did. Major errors included, but were not limited to, having a non-specific COD, omitting other significant conditions, and having an inaccurate underlying sequence of events. Overall, 125 patients met the criteria for the study. When considering errors, only 1 DC (0.8%) had no minor or major errors, 10 (8%) contained minor errors only, and 114 (91.2%) contained at least one major error (22 major errors only, 92 with both minor and major errors, 40 with multiple major errors). Regarding major errors, a non-specific COD was noted in 23 DCs (18.4%), other significant conditions were omitted in 103 (82.4%), and 57 (45.6%) contained an inaccurate sequence of events. While educational initiatives exist, they are lengthy and outdated. Creation of a revised, condensed learning module with a summary sheet for the learner upon completion has been developed to assist with the efficacy of finalizing DCs within the requisite 48-hour period. The effectiveness of the module is under evaluation using survey questions and knowledge-based questions given before and after completion of the educational initiative