Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
권호 표지

The effect of education on 'how to write the death certificate' for resident trainees of the emergency department

전공의를 대상으로 시행한 사망진단서 작성법 교육의 효과

  • Kang, Eunjin (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Hyeji (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sun Hyu (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 강은진 (울산대학교 의과대학 울산대학교병원 응급의학과) ;
  • 이혜지 (울산대학교 의과대학 울산대학교병원 응급의학과) ;
  • 김선휴 (울산대학교 의과대학 울산대학교병원 응급의학과)
  • Received : 2018.07.02
  • Accepted : 2018.08.14
  • Published : 2018.10.31

⟨ Previous Next ⟩

Abstract

Objective: This study investigated the most common errors on death certificates written by resident trainees of the emergency department and evaluated the effects of education on how to write a death certificate. Methods: A casebook of 31 deaths was prepared based on actual death cases in the emergency room in 2016. Ten residents completed 31 death certificates for the death casebook without any prior notice and then received education on 'How to write the death certificate.' They completed the death certificates again for the same casebook after receiving the education and the number of errors on all death certificates was again determined and divided into major and minor errors. The average number of error types was compared before and after the education. Results: Major errors occurred in 55% of all death certificates, but decreased to 32% after education. Minor errors decreased from 81% before education to 54% after education. The most common major error was 'unacceptable cause of death' (mean${\pm}$standard deviation [SD], $10.2{\pm}8.2$), and the most common minor error was 'absence of time interval' (mean${\pm}$SD, $24.0{\pm}7.7$), followed by 'absence of other significant conditions' (mean${\pm}$SD, $14.6{\pm}6.1$) before education. Conclusion: Education on 'how to write a death certificate' can help reduce errors on death certificates and improve the quality of death certificates.

Keywords

References

  1. National Medical Center. Statistics of emergency medicine 2016 [Internet]. Daejeon: Statistical Information Service; 2017 [cited 2018 Jun 18]. Avalilable from: http://kosis.kr/statHtml/statHtml.do?orgId=411&tblId=DT_41104_174&conn_path=I2.
  2. Kim MY, Lee SD. A proposal for writing a better death certificate. J Korean Med Assoc 2018;61:259-67. https://doi.org/10.5124/jkma.2018.61.4.259
  3. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151-210. https://doi.org/10.1016/S0140-6736(17)32152-9
  4. Kim HA, Kim KY, Kam S, et al. Accuracy of death certificates completed by medical students. J Agric Med Community Health 2010;35:89-98. https://doi.org/10.5393/JAMCH.2010.35.1.089
  5. Brooks EG, Reed KD. Principles and pitfalls: a guide to death certification. Clin Med Res 2015;13:74-82. https://doi.org/10.3121/cmr.2015.1276
  6. Al-Kubaisi NJ, Said H, Horeesh NA. Death certification practice in Qatar. Public Health 2013;127:854-9. https://doi.org/10.1016/j.puhe.2012.12.016
  7. Myers KA, Farquhar DR. Improving the accuracy of death certification. CMAJ 1998;158:1317-23.
  8. Lakkireddy DR, Basarakodu KR, Vacek JL, et al. Improving death certificate completion: a trial of two training interventions. J Gen Intern Med 2007;22:544-8. https://doi.org/10.1007/s11606-006-0071-6
  9. World Health Organization. International statistical classification of diseases and related health problems. 10th rev. Geneva: World Health Organization; 2010.
  10. Statics Korea. Korean standard classification of diseases. Daejeon: Statistics Korea; 2015.
  11. Shin HY, Lee S. How to write a death certificate: from a statistical point of view. J Korean Med Assoc 2018;61:268-78. https://doi.org/10.5124/jkma.2018.61.4.268
  12. Korean Medical Association. How to write and issue medical certificates. Seoul: Korean Medical Association; 2015.
  13. Kim KS, Lim YS, Rhee JE, et al. Problems in completing a death certificate. J Korean Soc Emerg Med 2000;11:443-9.
  14. Filippatos G, Andriopoulos P, Panoutsopoulos G, et al. The quality of death certification practice in Greece. Hippokratia 2016;20:19-25.
  15. Maharjan L, Shah A, Shrestha KB, Shrestha G. Errors in cause-of-death statement on death certificates in intensive care unit of Kathmandu, Nepal. BMC Health Serv Res 2015;15:507. https://doi.org/10.1186/s12913-015-1168-6
  16. Cambridge B, Cina SJ. The accuracy of death certificate completion in a suburban community. Am J Forensic Med Pathol 2010;31:232-5. https://doi.org/10.1097/PAF.0b013e3181e5e0e2
  17. Yoon SH, Kim R, Lee CS. Analysis of death certificate errors of a university hospital emergency room. Korean J Leg Med 2017;41:61-6. https://doi.org/10.7580/kjlm.2017.41.3.61
  18. Akakpo PK, Awuku YA, Derkyi-Kwarteng L, Gyamera KA, Eliason S. Review of errors in the issue of medical certificates of cause of death in a tertiary hospital in Ghana. Ghana Med J 2017;51:30-5. https://doi.org/10.4314/gmj.v51i1.6
  19. Haque AS, Shamim K, Siddiqui NH, Irfan M, Khan JA. Death certificate completion skills of hospital physicians in a developing country. BMC Health Serv Res 2013;13:205. https://doi.org/10.1186/1472-6963-13-205
  20. Statistics Korea. Annual report on the cause of death statistics in 2016. Daejeon: Statistics Korea; 2017.
  21. Baek D, Cho H, Moon S, et al. The current status of death certificate written in an academic hospital and the degree of agreement in interpretation: a single center observational study. J Korean Soc Emerg Med 2017;28:374-9.