What do we tell the Coroner? Clinicians understanding of reportable deaths in Victoria.

Within Australia the coroner has an important role in investigation of certain deaths. This investigation can inform the delivery of safe patient care. There are a group of deaths within healthcare settings that should be reported to the coroner by the clinical staff. This thesis examines the understanding of clinical staff as to which deaths meet the criteria for reporting and also the importance of the independent review by the coroner.