Linking hospital epidemiology and quality assurance: seasoned concepts in a new role

In this initial presentation, certain concepts central to infection control epidemiology have been discussed and related to the evaluation of noninfectious events in medical care. While most of the examples have focused on parallels in noninfectious hazards of hospital care, a more global evaluation of the functional benefit(s) and cost-effectiveness of medical care intervention using similar epidemiologic principles is possible and of equal value. These issues will be discussed in future presentations. It will be our continuing thesis that the current infection control practitioner and hospital epidemiologist will need to become more involved in the quality assurance and risk management activities of their institutions and that training in all fields of medical care evaluation will need to be founded in epidemiology. Programs in quality assurance and risk management must adopt the use of these standard methods and must generate the databases to allow variations from norms in clinical practice to be evaluated. Those in infection control will need to broaden their expertise to include more sophisticated statistical methods, newer strategies in the observational studies of clinical care, the fundamentals of clinical information systems and data handling, and the appropriate national and regional sources of comparative clinical data. Future articles in the Topics series will provide reviews in these areas and serve as a forum for issues in the changing field of hospital epidemiology. The editors welcome comments on the series or manuscripts for review for possible publication.