Does it matter who requests necropsies? Prospective study of effect of clinical audit on rate of requests

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Abstract
Since March 1991 we have audited the necropsy rate in a 112 bed department of acute medicine for the elderly. The results of an initial six month audit and the potential benefits of and possible barriers to achieving a high necropsy rate were discussed with members of the department, and the departmental policy of obtaining the highest possible necropsy rate was reinforced. The impact of our audit programme on the rate of necropsies obtained by medical staff was then observed over six months, during which we recorded request and refusal rates. On completion of this audit cycle, the patient affairs officer (JRJ) accepted responsibility for requesting necropsies as she believed that she could achieve a higher necropsy rate than the medical staff. Subsequent audit compared her performance with that previously achieved by medical staff. Over three successive years we audited the annual performance of the patient affairs officer and looked at the effect of relatives' refusal to give permission for necropsy.

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