I. Steps to take after a Patient Death at UNMH

• Examine and pronounce the patient.  Not comfortable with how to pronounce a patient?  Click here.
• Contact and notify family if they are not present 
• Enter a brief "death note" (template below) in the progress note section
• Nursing will print out some information, and they should fill out the "electronic expiration form."  Your info should have an instruction sheet on top that talks about your part.  The documentation is now electronic, and found under: adhoc->inpatient provider forms->death packet.  (this is explained with pictures on the provider instruction sheet).
• Complete the steps in the electronic death packet (includes calling OMI and Donor Services). Electronic death packet is an ad hoc form which can be selected as an order in Power Chart
• Residents are NOT responsible for contacting funeral homes/mortuaries or coordinating transport
• *Do a death summary, which is just like a discharge summary- but reflects the process of the patient passing away.
• Please send an email to the PCP informing them that the patient has passed away.  Use *secure* in the subject line.

*If you are Cross Covering a patient that passes away (like at night) you do not have to do the death summary- it should be done by someone who knows the patient well- often the intern following the patient, but you do have to enter a death note and contact the team with any details they will need.

II. Death Note Template (you can write this under an "Inpatient Provider Progress Note"

Called at _ by _ to pronounce _.

Time of Death: Patient was pronounced dead on _/_/_ at _:_.  

Brief HPI: _.

On exam, no heart sounds or breath sounds were noted after 1 minute of auscultation. Pupils were fixed and dilated without pupillary light reflex. 

Attending, Dr. _, was notified. 

Presumed Cause of Death: _

Family Notified: Family _was present/notified by phone and condolences were offered. 

Death packet has been completed.  The organ donor network was notified and the case was _accepted/declined.  The case was reported to the office of the medical investigator.

Autopsy was offered to family and family has elected to _have/not have an autopsy.

III. Death Summary Template

Use the same dictation code as a discharge summary: 01

Sections

Admission Date

Date and Time of Death

Attending at Time of Death

Admitting Diagnoses

Diagnoses at Time of Death

Hospital Course, highlighting events surrounding the patient passing away

(you do not need a dc med list)

IV. More info

• Forget how pronounce someone? Click here
• nicely written blog post about how it feels to pronounce someone for the first time, written by a physician
• Great article about Dr. Steven Hsi, a local physician who wrote a book when he learned he was dying.