Audit of necropsy reporting in East Anglia.

AIMS: To establish criteria for the information to be included in a necropsy report, and to improve the quality of necropsy reporting in the Anglia Region. METHODS: Discussion between Anglia histopathologists, based on the guidelines of the Royal College of Pathologists, led to a consensus about the ideal content of a necropsy report. Fifteen consecutive necropsies subsequently undertaken by each consultant were assessed against agreed standards. Reaudit was undertaken nearly two years later, without prior announcement. RESULTS: The initial standards achieved for demographic details (70%), history (87%), external examination (43-97%), internal examination (76-95%), organ weights (73%), cause of death in OPCS format (94%), and conclusion (90%) were discussed by the group. Changes to necropsy reporting documentation were proposed. Reaudit showed improvement in nearly all categories. CONCLUSIONS: Necropsy reporting in East Anglia is currently carried out to a reasonably high standard, and improvements have occurred as a result of the audit. There was no evidence that reports on coroners' necropsies were of a lower standard than those done for the hospital. Improvement in the format of the documentation increases the likelihood that all relevant and important data are recorded.

The use of histopathology in the practice of necropsy.

AIM: To examine current practice and to establish criteria for the use of histopathology in necropsy practice. METHODS: During an audit of necropsy reporting, consensus could not be reached about the use of routine histopathology. Therefore local guidelines were formulated and current practice was compared with these guidelines. Fifteen consecutive necropsies undertaken by each consultant were reviewed and the use of histopathology noted. RESULTS: In general, the standard of necropsy reporting was reasonably high. Tissue was retained for histopathology in 25% of necropsies and 72% of these necropsy reports included a histopathology report. Using the guidelines, the assessors judged that histopathology might have been valuable in a further 19%. It was felt that routine histopathology would not have been helpful in determining the cause of death in the remaining 56%. The importance of the pathologist's clinical judgement in individual cases was stressed. At reaudit, nearly two years later, there was no significant change in practice, reflecting the lack of consensus. CONCLUSIONS: Even when histopathology might contribute to finding the cause of death, it was not always done. However, the assumption that histology is invariably helpful in determining the cause of death is challenged.