Publish date: 31 March 2022
To further improve our approach to learning from deaths we will be making an amendment to the death reporting process on Datix for Community, Local and Secure divisions from 1 April 2022. This standardises the process across the Trust and ensures clinical oversight of deaths within teams with correct reporting on harm (if any) when a death has occurred.
Deaths should continue to be reported in the usual way via the death reporting form on Datix. From 1 April 2022, reporters will notice that they will be requested to name the reviewer – this should be the same reviewer as for any other incident they report (usually a team leader or manager).
The reviewer should complete the very basic review of the ‘incident’ reported as for any other Datix incident. The reviewer should ensure that the category/sub- category match the death as reported and as recorded from the clinical history. Ideally the reviewer should note any cause and location of death given.
- The reviewer should ensure the level of harm selected is appropriate for the death – almost all will be no harm. Deaths as a result of a patient safety incident are rare.
- The reviewer should approve the incident
- The death can then be triaged by the Mortality team according to the scope of the Trust policy.
This approach has several benefits:
- As noted, this allows for clinical oversight within the reporting team
- Deaths will be reported accurately, ready for upload to the National Reporting and Learning system
- The mortality review process will be simplified for all
The Trust Learning from Deaths Policy (SA45) details the process being used.
