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. Design.-An objective analysis of the Autopsy Service's organization, functions, and process flow to identify facto rs that impact the autopsy rate. Setting.-The University of Texas Medi cal Blanch 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 ol: each significant event was analyze d. Results and 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. Tile Texas Department of Criminal Justice Hospital contributed the largest number of medicolegal autopsies. We conclude that the following key f actors contribute to our high autopsy rates: (1) the organization and multiple functions of the Autopsy Service, particularly the presence o f a Decedent Affairs Office, dedicated resident assignments, and inter nal and external quality control of the autopsies; (2) close interacti ons with clinicians, including timely communication of autopsy results to clinicians and a fostering of positive attitude among clinical res idents and faculty; and (3) other factors such as the contributions to hospital risk management, disproving the idea that there may be incre ased litigation related to high autopsy rates, and support by the hosp ital administration.