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. 2022 May;42(5):671-676.
doi: 10.1038/s41372-021-01214-3. Epub 2021 Sep 28.

Mortality in the neonatal intensive care unit: improving the accuracy of death reporting

Monica H Wojcik  1   2   3 , Jenny Chan Yuen  4 , Anne Hansen  4   5 , Kristen T Leeman  4   5
Affiliations

Mortality in the neonatal intensive care unit: improving the accuracy of death reporting

Monica H Wojcik et al. J Perinatol. 2022 May.

Abstract

Objective: Death certificates commonly contain errors, which hinders understanding of infant mortality. We, therefore, undertook a quality improvement (QI) initiative to improve death reporting in our neonatal intensive care unit (NICU).

Study design: After our baseline assessment (January 1, 2015 to June 30, 2017), we implemented our QI initiatives using Plan, Do, Study, Act (PDSA) tests of change. We prospectively reviewed death certificates (July 1, 2017 to December 31, 2019) to evaluate the impact of our interventions.

Results: The overall proportion of incorrect death certificates significantly decreased from 71 to 22% with special cause variation noted after the second PDSA cycle. The most common errors involved inaccurate or incomplete reporting of prematurity and errors in the sequence of events.

Conclusion: Through a series of PDSA cycles focused on formal provider education and ongoing review, we significantly reduced inaccurate death reporting. These interventions are generalizable across NICUs and important to improve public health reporting accuracy.

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Conflict of interest statement

Competing Interests: The authors have no competing interests to disclose.

Figures

Figure 1.
Figure 1.
Cause and effect diagram. The causes addressed by this QI project are highlighted by the shaded boxes.
Figure 2.
Figure 2.
Common errors on death certificates.
Figure 3.
Figure 3.
Control chart, with interventions noted in boxed text. The data are displayed over time in a statistical process control p-chart, where the data represent a rate with the numerator of the number of accurate death certificates and denominator of total number of death certificates per month
See this image and copyright information in PMC

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