Autopsy result utilization - College of American Pathologists Q-Probes study of 256 laboratories

Objectives.-To document the level of involvement and communication with non pathology clinical personnel regarding autopsies and to document the destin ation of autopsy reports. Design.-The College of American Pathologists Q-Probes format was used to co llect information on 15 consecutively performed autopsies per institution o r for 6 months, whichever occurred first. The following information was rec orded for each autopsy: decedent's age, hospital service, length of hospita l stay, whether organs were donated, who was present at autopsy, methods of communicating preliminary and final autopsy results, special techniques us ed to arrive at a preliminary diagnosis, activities for which the autopsy w as used, and destination of final report. Participants.-Two hundred fifty-six laboratories collected information on 2 755 autopsies. Results.-The aggregate autopsy rate was 12.4% (median 8.5%). Nonpathology c linical personnel attended 35.8% of all autopsies. A clinical physician was more likely to attend an autopsy if the patient was from a surgical servic e. Three primary methods were used to communicate preliminary autopsy resul ts, namely, written reports (82.5%), telephone calls (50.6%), and meetings (11.5%). The primary care physician was sent the autopsy report in 91.1% of cases. Approximately half of the autopsy cases were used in both pathology departmental and extradepartmental activities. Aggregate autopsy data were distributed in the majority of cases to various departmental chairpersons and institutional quality assurance committees. Conclusions.-This study provides a comparative multiinstitutional database for the utilization of autopsy results by clinicians and clinical departmen ts. Although autopsy rates are low, autopsy results are routinely being use d for hospital quality assurance activities and for educational purposes.