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Using rich picturesImproving the Process of Death Certification                                               I decided to...
Current System: People, Process & TechnologyImproving the Process of Death Certification                                  ...
“Word picture” used in design of rich-pictureImproving the Process of Death Certification                                 ...
“Word picture” used in design of rich-picture continuedImproving the Process of Death Certification                       ...
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Death Certification Reforms Rich Picture Of Current People, Process And Technology

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This presentation shows a rich-picture that I designed and commissioned for work with the Department of Health\’s Death Certification Programme. It was great fun to design and always had a significant impact on participants at workshops and attendees at conferences.

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Death Certification Reforms Rich Picture Of Current People, Process And Technology

  1. 1. Using rich picturesImproving the Process of Death Certification I decided to design and commission the rich picture shown opposite to illustrate the whole- system within which the current process of death certification operates. The picture tells a story to people who are familiar with the process and is an excellent mechanism to get everyone „on the same page‟ at the start of a presentation or workshop. It also allowed the inclusion of allegorical references to issues with which many people were familiar. The rich picture is intended to be illustrative rather than accurate or complete and was See slide 2 for a full-size copy of the rich picture. accepted as such without causing any offence. Whenever it was used, I always offered people an opportunity to suggest any additions or changes. The picture was drawn by Richard Duszczak at the Cartoon Studio based on a “word picture” that I provided and a number of discussions. This “word picture” is included on slides 3-4. 1
  2. 2. Current System: People, Process & TechnologyImproving the Process of Death Certification 2
  3. 3. “Word picture” used in design of rich-pictureImproving the Process of Death Certification • A crooked and rickety bridge over a river. End-of-Life Care on left bank of river and Bereavement (including registration, Tell-Us-Once, funeral, counselling, probate, ONS etc.) on right bank. • Death Certification & Bereavement Services are on the bridge with the latter guiding / supporting a bereaved person who is blindfolded and / or bent-over holding their heads in their hands. • A walkway off the middle of the bridge leads down to small island in the river that represents the Coroners Service with officers speaking to police / doctors / families and either issuing Form As or requesting post- mortems / conducting inquests. • The post-mortems and inquests could additional islands upstream linked by a walkway from the first island and connected to the right-hand bank by a bridge or possibly a well-maintained row-boat. • A second walkway off the bridge leads to a platform for completion and secondary certification of cremation forms - there is a rope swing from this platform to the right bank. 3
  4. 4. “Word picture” used in design of rich-picture continuedImproving the Process of Death Certification • There are people standing on both banks of the river. – On the left bank, these people might include: hospital and community nurses, doctors, palliative care teams, patient safety teams, police officers, paramedics and (at the foot of the bridge) bereavement volunteers. – On the right bank, the people might include: registrars, local authority bereavement support officers (using the Tell-Us-Once system), funeral directors (beckoning the bereaved forward), faith community leaders (looking at the setting sun), other relatives, medical referees (in football boots??), cemetery / crematoria staff, bereavement counsellors and ONS / statisticians. • The bridge has broken handrails, and multiple / confusing signposts. There are gaps in the bridge with things falling through to reflect inaccuracies in the causes of death. • The people on either side are looking away from each other to represent the preference for focusing on using what they know to complete what they need to get done. • Bereaved people are being processed across the bridge rather than properly supported and listened to. 4

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