Get Form Bp-a563.044, Multi-level Mortality Review - Federal Bureau Of ... - Bop

Filling out the Form BP-A563.044, Multi-Level Mortality Review, is a crucial process for documenting the circumstances surrounding a mortality event within the Federal Bureau of Prisons. This guide will provide you with clear, step-by-step instructions to ensure that you can easily complete the form online and accurately capture all necessary information.

Follow the steps to successfully complete the Multi-Level Mortality Review form.

1. Click the ‘Get Form’ button to access the Multi-Level Mortality Review form and open it in your editing interface.
2. Begin by filling out the date, recipient, sender, and subject fields at the top of the form. Make sure to include the name, registration number, date of death, date of birth, age, and place of death.
3. Indicate the name of the community hospital and the nature of death, selecting from options such as natural, accidental, homicide, or suicide. Fill in the corresponding details about the race and cause(s) of death.
4. Provide a narrative summary that details the date of admission to the institution, including if the individual was a new commit or a transfer. Provide significant past diagnoses related to the individual's health history.
5. Outline the description of the course of illness, detailing past and present conditions, treatments, medications, and any diagnostic findings. Include necessary diagnostic exams as indicated.
6. Review the institution medical care section, indicating the severity of illness, appropriateness and timeliness of diagnostic procedures and treatment, and any complications that affected the outcome.
7. Complete the local community hospitalizations section in a similar manner, addressing severity, diagnosis, treatment, and complications.
8. Evaluate if death was related to a medical emergency by addressing response times of medical staff and the adequacy of care received.
9. Summarize your review, indicating if the patient received appropriate care according to community standards, and include comments about strengths and weaknesses observed during care.
10. Attach necessary documents, including the medical record, death certificate, narrative summary, and any autopsy report or other relevant documents, as specified.
11. Once all fields are complete and reviewed, you can save changes to the form, download a copy, print it for records, or share it with the relevant stakeholders.

Complete the Multi-Level Mortality Review form online to ensure accurate documentation and adherence to protocols.