The University of Melbourne has developed a simple death certification assessment tool to facilitate periodic evaluation of the impact of COD certification training. The tool is based on commonly reported death certification errors that affect the correct identification of the sequence of events leading to death and the UCOD. These errors include:

1. Documenting multiple causes per line in Part 1 
2. Not reporting the time interval from onset to death
3. Leaving blank lines within the sequence/chain of events 
4. Use of abbreviations when certifying the COD 
5. Illegible handwriting 
6. Incorrect/clinically improbable sequence of events leading to death 
7. Ill-defined condition(s) entered as the UCOD 

This tool can be used to assess the baseline level of certification accuracy and to measure the impact on certification behaviour after training. This tool can also be used to periodically assess the death certification accuracy and to provide a feedback to the certifiers. This tool is designed to assess the quality of death certification practices through checking for the presence of common errors in death certificates. This can be used to assess the quality of death certification as part of routine assessment, or to assess the training needs of physicians in designing COD certification training. This tool can also be used to evaluate the impact of death certification training.

This tool can be used by a physician  who is trained in death certification practices and understands the ICD death certification rules. The tool can also be used by a well-trained coder to assess diagnostic accuracy of physician certifiers. The tool is essentially a checklist of the most common errors that are seen on death certificates.

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Health Information Systems Knowledge Hub (2009).  Promoting the periodic assessment of the quality of medical records and cause-of-death data: lessons learned from a medical records study in Sri Lanka.  University of Queensland. 

Health Information Systems Knowledge Hub (2013).  Assessing the reliability of hospital-based cause-of-death statistics: evidence-based guidelines for country application.  University of Queensland.

Purdy C (2013).  The mortality assessment for health programs (MAP) system.  Baltimore MD: Johns Hopkins Bloomberg School of Health.

Rampatige R et al. (2014).  Systematic review of statistics on causes of deaths in hospitals: Strengthening the evidence for policy-makers.  Bulletin of the World Health Organization.