Surveillance, Reporting, Automation, and Interventional Epidemiology

A commonly accepted definition of public health surveillance is "the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know." 1 The scientific basis for surveillance as a part of a hospital infection control program was established by the landmark Study on the Efficacy of Nosocomial Infection Control (SENIC).The SENIC project was born out of the frustration to justify infection control programs that had been instituted in thousands of hospitals in the 1960s and 1970s. 2 The SENIC investigators recognized (and wished to measure) how the surveillance activity itself could influence patient care through the Hawthorne effect (ie, how healthcare workers may alter their practice when they see that someone is watching and is interested in how they are caring for patients). 3t the time of the first SENIC survey in 1976, most (86%) of the 1,518 infection control practitioners spent half or more of their time in surveillance activities. 4The SENIC project found that reduced rates of nosocomial infections were strongly associated with intensive surveillance activities, although at least moderate levels of control activities were also required for effectiveness. 5The SENIC study design was thorough, ambitious, and technically sophisticated, but it was based on retrospective chart reviews in a large sample of hospitals and not, as sometimes stated, on a controlled trial. 6he incremental and slow development of definitions and methods for surveillance of healthcare-associated infections was reviewed by Hierholzer at the Third