Using the definition of 20 weeks' gestation to 1 month of age for perinatal encompasses the understanding of pathologists and the legal world, which in many states requires an autopsy permit for autopsy examinations on fetuses and infants older than 20 weeks gestational age.
(17,18) In many cases, autopsy permits refinement of further diagnostic testing, including guidance in selection of costly genetic testing.
Autopsy Service Quality Improvement Initiatives Increase the visibility of the service Conferences Morbidity and mortality Orientation Death certification Autopsy card The Decedent Affairs Program Administrative packets New module for clinical support system Family informational pamphlet Improve the service's reporting Better communication with clinicians Phone calls to clinicians New autopsy permit More complete provisional reports Rush histology service Cause-of-death statements Better turnaround times to final report Establishing mechanics Packaging case at time of provisional anatomic diagnosis Changing attitudes Increase the amount and quality of data Autopsy rate and request rate data Clarification/discrepancy data Quarterly reports
In addition, since the "consultation request" portion of the autopsy permit was rarely filled out, key clinical questions often remained unknown to us and therefore may not have been addressed in the report.
The greatest improvements were in the timeliness of final reports (P [is less than] .001), the ease of the autopsy permit process (P [is less than] .001), and the perceived accessibility of the pathologists (P [is less than] .01).
Also improved were the ease of the autopsy permit process, resulting from efforts of the autopsy service and the Decedent Affairs Program.