Marking a patient deceased in Epic is a critical clinical responsibility that must be performed accurately, respectfully, and in compliance with facility policy and regulatory requirements. This process impacts billing, reporting, and care transitions, so it is important for clinicians and staff to follow a consistent, verified workflow.
Below you will find a practical guide to completing this task in Epic, including key steps, system locations, common issues, and answers to frequent questions from frontline users.
| Workflow Phase | Key Action | Epic Module | Verification Needed |
|---|---|---|---|
| Preparation | Confirm death at the bedside with required providers | Care Everywhere / Results Review | Provider time/date documented |
| Location | Navigate to Patient List or Chart Search | Patient List | Correct patient selected |
| Documentation | Enter date/time and provider signature in Flowsheets/Notes | Flowsheets, Notes | Time zone recorded accurately |
| Post-Mark Tasks | Run discontinuation orders, notify ancillary services | Orders, Ancillary Scheduling | Order sets reviewed and sent |
Accessing the Patient List in Epic
The first step to mark a patient deceased is to open the correct patient chart from a reliable list. Use the Patient List filtered by location, such as the unit or service where the death occurred, to reduce selection errors.
Using Patient List Filters
Apply filters for census status, location, and provider queue to narrow the list. Verify bed and room number before opening the chart to ensure you are working on the right patient.
Documenting Time of Death in Flowsheets
Flowsheets provide a structured way to record the time and date of death, which feeds into other downstream processes such as reporting and billing. Accurate timestamps are essential for compliance and for family notifications.
Mortality Flowsheet Entry
Open the relevant Flowsheet section, locate the row for time of death, and enter the exact date and time. Save and sign the entry according to your site’s authentication standards, and review the change audit trail if available.
Completing the Death Note in the Notes Module
A formal death note is typically required to capture clinical details surrounding the death, including circumstances, last treatments, and pronouncing provider information. This note serves as a medicolegal document and a reference for external agencies.
Note Template and Required Fields
Use the designated death note template when available. Ensure fields such as admitting diagnosis, terminal diagnosis, time of death, and provider signature are completed. Co-signature or attending review may be required depending on policy.Discontinuing Orders and Ancillary Services
Once the death is marked, orders must be appropriately discontinued to prevent unwanted interventions and to align with billing and compliance requirements. Ancillary services also need to be notified to close loops for housekeeping, security, and spiritual support.
Running Discontinuation Sets
Run discontinuation order sets for the deceased patient, verify that medications, IV fluids, and monitoring are appropriately stopped. Notify pharmacy and case management as needed, and confirm that the scheduling for any pending tests is canceled to avoid unnecessary resource use.
FAQ
How do I verify I have the correct patient before marking them deceased in Epic?
Confirm the patient identity by checking at least two identifiers, such as name and medical record number, on the Patient List and in the chart header before entering any death information.
What should I do if the time of death timestamp is incorrect after I save the flowsheet?
Use the appropriate correction or amendment workflow in Epic, document the reason for the change, and ensure the updated time is reviewed and signed according to your facility’s policy.
Who should sign the death note in Epic when multiple providers are involved?
The attending physician or the provider who pronounced the death typically signs the death note, and a second provider may be required for co-signature based on institutional policy and jurisdictional regulations.
How do I ensure ancillary services are notified immediately after marking a patient deceased?
Trigger discontinuation order sets and use secure messaging or scheduled tasks within Epic to alert case management, housekeeping, and security, then verify completion through task logs or callback confirmation.
Key Operational Practices for Accurate Patient Demise Documentation
- Confirm death at the bedside with required providers and record exact date and time
- Use Flowsheets to enter time of death in the designated mortality field
- Complete a structured death note with admitting diagnosis, terminal diagnosis, and pronouncing provider
- Run discontinuation order sets and notify ancillary services promptly
- Verify compliance with facility policy, regulatory, and billing requirements
