[EXTERNAL] [IMPROVEDX] Two posts on the topic of Autopsy as it relates to quality
Rana.Samuel at VA.GOV
Fri Jun 21 20:47:47 UTC 2019
I completely concur with everything you’ve said, and can provide several similar examples from my own practice over the years.
The problem is that the autopsy is only a tool and while it can be expected to always improve the accuracy of the cause of death listed on the death certificate, it may not lead to real improvements in care without an organizational culture that promotes learning and systemic corrective actions.
How many institutions go through the motions of an RCA to meet accreditation requirements, without the RCAS resulting in durable, meaningful change?
How many hospitals in areas where it is hard to recruit providers overlook a higher than average complication rate in a surgeon because he brings in 40% of patients that are admitted to the hospital? Or rationalize a high post-op infection rate in an orthopedic surgeon, because he was the only one they were able to recruit, and the joint replacements are what is keeping the hospital afloat?
I for one would like to see the autopsy redeployed as an accreditation requirement with teeth – with surveyors following up on institutional actions taken after an autopsy reveals a significant difference between the antemortem and postmortem diagnosis.
Thanks for sharing these links.
Rana Samuel, MD, FCAP
Chief, Pathology and Laboratory Medicine Service (PALMS, 113)
Medical Review Officer, Federal Drug Free Workplace Program (DFWP)
VA western New York Healthcare System (VAWNYHS)
3495 Bailey Avenue, Buffalo, NY 14215
Lead pathologist – VISN 2
Regional Commissioner, Region 2, National Enforcement Office
Rana.samuel at va.gov
From: Edward Winslow <edbjwinslow at GMAIL.COM>
Sent: Wednesday, June 19, 2019 3:21 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [EXTERNAL] [IMPROVEDX] Two posts on the topic of Autopsy as it relates to quality
I have posted two notes on the Autopsy. While I realize that this is "Preaching to the Choir" taking to this group about the Autopsy, I thought that we may be interested in how and when what happened did.
I would love to know what you all think. Also, I would like the Executive of SIDM to consider leading the rest of the professions in trying to reinstate the autopsy.
A Tale of Three Autopsies: http://winslowmedical.com/archives/181
A Follow Up on the Autopsy: http://winslowmedical.com/archives/185
I hope to hear from some of you.
Edward B, J. Winslow, MD, MBA
Home 847 256-2475; Mobile 847 508-1442
edbjwinslow at gmail.com<mailto:edbjwinslow at gmail.com>
“...the more you know about the past, the better you are prepared for the future.”
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