Making the case for personal professional monitoring in health care

Abstract
The use of databases to identify both good and bad (acceptable and unacceptable) trends in the performance of simple and complex procedures in medicine has a long history and was advocated by such important medical and nursing practitioners as Florence Nightingale, Ernest Codman, Lord Moynihan and others [1–7]. Unfortunately, not all of these committed clinicians have gained the respect of their local medical colleagues [2,8,9]. Thus the need for objectively endorsed systems to monitor the occurrence of adverse clinical outcomes in day-to-day practice is paramount [10–12]. In pursuit of this goal the article by Spiegelhalter et al. in this issue is a welcome contribution [13].
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