Systems are changing: where can they be improved?

Wide-ranging changes of unprecedented scale throughout the delivery of healthcare services are producing consequences we cannot ignore. A need to collaborate to improve healthcare systems is evident. The Society for Healthcare Epidemiology of America (SHEA) and the Health Care Division of the American Society for Quality are responding in jointly sponsoring this symposium concerning problems with medical devices. This presentation and those that follow will explore the quality of management of managed-care corporations; the important threat to out primary source of innovation in medical technology posed by behaviors of consolidated corporations; the impact of these changes on roles of hospital epidemiologists; and measures to ensure proper design, production, delivery, and use of safe medical products. Our profession and SHEA have made significant research-based contributions that document their potential value, but we have not always done as well as we could to market epidemiology as an important asset for sound management decisions in this era of change. We should ally ourselves with related disciplines in order to succeed as we undertake new challenges on a broadening field.