Routine mortality monitoring for detecting mass murder in UK general practice: test of effectiveness using modelling

Abstract

At best, mortality monitoring can act as a backstop to detect a particularly prolific serial killer when other means of detection have failed. Policy should focus on changes likely to improve detection of individual murders, such as reform of death certification and the coroner system. Keywords family practice; homicide; outcome and process assessment (health care); quality assurance, health care; regulation. B Guthrie, PhD, MRCGP, professor of primary care medicine;

CUSUM charts for monitoring clinical practice quality using primary care prescribing data: a case study of an initiative to encourage generic prescribing of proton pump inhibitors

“…There, it is clear that their usefulness will depend on the ‘event rate’ being monitored. Specifically, it seems likely that they are more suited to identifying mortality ‘outliers’ in hospitals (11) than for individual doctors in general practice (12). This case study suggests the technique has also wider application.…”

Commentary: Monitoring mortality: a quality improvement perspective

“…1 Monitoring is a method for detecting and acting on signals in data for a range of problems -not just one problem. We monitor patients' temperature postoperatively not just to detect wound infection, but any infection (or even hypothermia).…”

Making haste slowly: the response to the Shipman Inquiry?

“…In this issue of the Journal, Bruce Guthrie and colleagues provide evidence on the feasibility of mortality monitoring. 5 They used a variety of statistical techniques with a simulated dataset in the context of Scottish general practices. The findings are important in showing the limitations of monitoring, including the high level of false alarms and the difficulties caused by the frequency with which doctors switch practices.…”

“…With respect to reform of the coroner service and associated changes to cremation and death certification, which are key to detecting unlawful killing by health professionals, 5 progress has been slow. The Department for Constitutional Affairs has presented a draft bill for consultation, but the rather modest proposals of the Bill were heavily criticised.…”