Death notification in a Mexican Emergency Department: clinical observations

Abstract

Background: Death notification is a frequent task in emergency departments, emergency physicians don’t receive formal training to do it which affects all stakeholders. GRIEV_ING protocol has been proposed as an effective training program that use behavioral direct observation to evaluate physician’s competence, nevertheless, these evaluations are done in simulated environments and has been conducted in different cultural and structural settings from those of Mexican context, which reduces the precision of data and limits its generalizability. Aim: To carry out an observational clinical record of real death notifications delivered by emergency physicians from a general hospital in Mexico City. Method: The GRIEV_ING observational check-list was used to evaluate the performance of 25 emergency physicians who delivered 52 death notifications. Results: Doctors performed 48% of suggested behaviors. Around 74% of death notifications were given in the hallway or waiting room. The most frequent behaviors were aimed at providing information about the clinical aspects of death and physicians were attentive in their interaction with the survivors. Less frequent observed behaviors were: making sure the survivor understood the medical information; providing contact information; and giving information about post-mortem processes. Conclusion: This study represents a first step in develop of death notification training programs tailored to the physical and cultural conditions of the Mexican health system.

Keywords

• Truth disclosure. Behavior observation techniques. Emergency service. Hospital.