Decedent Care Guidelines for Physicians and APPs at Stanford Health Care
In this guide, physicians and advanced practice providers at Stanford Health Care are provided with detailed instructions on handling decedent care from reporting to the coroner to completing the death certificate. The guide includes steps for contacting the Medical Examiner-Coroner's Office, addressing loved ones, and completing the death certificate accurately. Important information on the importance of death information, autopsy procedures, and completing necessary documentation is also covered.
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Decedent Care Quick References for Physicians and APPs: Medical Examiner-Coroner s Office, County of Santa Clara: Interaction and Reporting Guidelines, January 2020. (located online) Decedent Care Physicians and APPs for reference and printing (located on Stanford intranet, COVID19 resources for Physicians and APPs; On-call Chaplain has a copy, if needed) Death of a Patient policy (located on Stanford PolicyTech; revision forthcoming Fall 2020) SHC Decedent Care Chaplain (contact via Voalte or pgr 25683, 24/7)
Step 1/3: Call the Coroner (MEC)? See Decedent Care Physicians and APPs, page 1 Reporting to the Coroner is not the same as a Coroner s Case. Many deaths need to be reported, but not all reports will be cases. See list of reporting reasons on page 1 of the above resource. WHO reports and WHEN: RN, APP, or MD calls immediately following legal death (wait on hold if needed). Document the call in EPIC death certificate worksheet, Coroner section of the medical record, including Release/Case number/declined, MEC Badge number and Name.
Step 2/3: Address Loved Ones, Autopsy See Decedent Care Physicians and APPs, pages 1, 4-8 Notify Loved Ones of patient s death. Ask about an Autopsy (per Death of a Patient policy, pages 4-8): A. team if they would be willing to give consent for an autopsy at the hospital. The next of kin of all inpatients dying from natural causes will be asked by a member of the medical B. forms or ask the On-call Chaplain for a consent form). When a family leaves the hospital without giving permission for an autopsy and decides they do want to give consent for an autopsy, a physician from the Primary Team calls the family member on a recorded line to obtain consent. A medical team member will review and complete the consent form with the family member (see e- C. consent for an autopsy. The recorded consent requires reading the entire text of the front page of the consent. The paper Autopsy Consent form must still be completed on both sides and include an accurate date and time of recording, be signed by the physician, and then transported as noted in D. below. To arrange for a recorded consent, contact 3POST at 650-723-7678, and say you need to record a D. If there is to be autopsy, the Unit Secretary calls 650-725-4978 to notify Autopsy Service Office about consent and also arranges for the chart to be transported to Autopsy Service Office located on the 2ndfloor Lane Building L 226 (door slot for dropping off anytime day or night). For assistance, contact Autopsy Service Attending Physician pager 1-3216.
Step 3/3: Complete the Death Certificate See Decedent Care Physicians and APPs, pages 1-3 WHY death information important? Data used for (1) Health Department and WHO epidemiology and (2) processing death certificate, which enables loved ones ability to bury/cremate HOW and WHO completes death certificate worksheet? Following legal death, primary team member familiar with the decedent Discharge Discharge as Deceased Complete EVERY section. NOTE: For ED deaths deemed not Coroner s cases, Attending at time of death completes this worksheet. Causes = reflect the WHY of death, the disease process; common mistakes and wording are addressed on pages 2-3 of the above resource. Primary team is responsible to assist with questions from the Health Department. ATTESTING death certificate? The Attending at time of death (or designee) attests; if unavailable, Attending of primary team responsible to attest. NOTE: In the ED, if Attending at time of death unavailable, ED Administrator On-call. Attestation may be faxed (for signing or voice attestation) or emailed (for voice attestation). ALL legally due within 15 hours of death.