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Quality Assurance, Infection Surveillance, and Hospital Information Systems Avoiding the Bermuda Triangle

Published online by Cambridge University Press:  02 January 2015

R. Mertens*
Affiliation:
Institute of Hygiene and Epidemiology, Hospital Hygiene Program Medical Informatics Department, J. Wytsmanstraat, 14 Hazenakkerstraat 20, 1150 Brussels, 9520 Zonnegem, Belgium
W. Ceusters
Affiliation:
Office, Line Engineering NV, Hospital Hygiene Program Medical Informatics Department, J. Wytsmanstraat, 14 Hazenakkerstraat 20, 1150 Brussels, 9520 Zonnegem, Belgium
*
Hospital Hygiene Program Medical Informatics Department, J. Wytsmanstraat, 14 Hazenakkerstraat 20, 1150 Brussels, 9520 Zonnegem, Belgium

Extract

The measurement of quality is a key feature in any quality assurance (QA) program, and the appropriate way to measure quality is by using epidemiological methods. Moreover, in the field of hospital hygiene, epidemiological surveillance has proven to have a powerful preventive impact by itself. Surveillance has been defined as the routine collection of data utilizing a systematic method and standard definitions with the aim of giving feedback in the form of tables, charts, and summary statements.6 The establishment of clear definitions and the collection of accurate data are essential prerequisites. The merits of a surveillance system, as well as its credibility when its results are used for the improvement of the quality delivered by individual caregivers or institutions, not only depend on the quality of the data, but also largely on the system's ability to do justice to the wide variability in the intrinsic and extraneous risk status of the exposed populations. Whenever comparisons are made, be it with one's own performance in previous periods or with other colleagues or external standards, the minimum requirement is that proper adjustment or at least stratification be performed by the principal risk factors. As a consequence, in many instances it is insufficient to collect data on the complications specifically addressed by the quality program, but also on a series of relevant risk factors. Likewise, these data are often not only to be collected for the cases with the adverse outcome, but also for the rest of the denominator population that is exposed to the risk, unless other sources exist from whence these data can be obtained. These requirements certainly put a burden on any surveillance activity for quality assurance and, as such, for the prevention of nosocomial infections.

Type
Statistics for Hospital Epidemiology
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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