MCCD Quality Improvement Project

Project Lead: Phoebe Li Aisha Elagili Wen Hui Lee


To improve the percentage of completing MCCD within 72 hours up to 75% or above by 7th May 2023 in Ward 100 in Hull Royal Infirmary.

Why is this important to service users, carers, and/or staff?

The rate of MCCD completion within 72-hours from 31st October 2022 to 27th February 2023 is below the target of 75% in Hull Royal Infirmary.

Completing MCCD within the time frame is crucial, as it can delay the funeral for the patient’s family or relatives and cause great distress.

Tests of change

We have generated a poster, circulated it among the junior doctors around the WhatsApp group and placed it in the doctor’s office. We also locate the death certificate booklet for junior doctors so they can access it easily.

For measurement: we will collect the data via the Medical Examiner Office. The ME has collected data and organised it in a spreadsheet. It states the number of death and the date, and when the MCCD is completed.

We will then trace if there is any delay in completion, discuss with ward staff what the reasons are and see how we can improve it in the next cycle.

Tools and how we used them

Results: What did the data say and what were the outcomes?

During the first cycle:

  • 2 weeks duration from 24th April to 7th
  • Three deaths in total – two completed on time, and one is still not completed.

We then investigated what caused the delay. The incomplete case is a complex death and is referred to the Coroners. It requires extra time to discuss with the Coroners and Seniors for completion. Therefore, our group jointly agree that we could treat it under the exclusion criteria.

Learning and next steps

The next step is we would like to organise a teaching to further enhance the Junior Doctor training in MCCD (as per Driver Diagram). We can also include some complex deaths in the teaching and inform seniors to provide support promptly.

We are also hoping to include ward 10 into our QIP as well to increase the sample size in Cycle 2. We will reach out to the Junior Doctors in Ward 10 to see if they are interested in joining.

In Cycle 3, we are hoping to seek for new F1s to continue the QIP and teach them about MCCD in the induction.

Can we help? Got an idea?

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