Accreditation Standards for Medicolegal Death Investigator Staffing: Pilot Study of Caseload and Workload Complexity.

One important way to ensure quality and standardization of medicolegal death investigation is medical examiner/coroner (ME/C) office accreditation. The two existing accrediting bodies for ME/C offices (National Association of Medical Examiners and International Association of Coroners and Medical Examiners) both specify autopsy caseload limits as part of accreditation standards; however, no such benchmark staffing number exists for medicolegal death investigators (MDI) in office accreditation standards. This pilot study assesses which model for MDI staffing is preferred as an accreditation item, subjective job stressors, typical MDI job tasks, and whether other "workload" complexity factors should be considered for MDI staffing in future accreditation standards. Results from 333 total respondents in an online questionnaire show: (1) the vast majority favor MDI workload standards, (2) the majority indicate the standards should be based on either jurisdiction population, the number of cases investigated by the office, or by the number of ME/C deaths in the jurisdiction, (3) MDI jobs require "extensive mental effort," (4) MDIs have feelings of workplace anxiety, stress, and a marked need for situational self-control, and (5) workload considerations for indirect investigative activities and individual case complexity for non-natural deaths should be considered when developing MDI workload staffing standards.