Figure 4-2 Postdischarge SSI surveillance. Source: Sands et al., 1996, 1999.

The goal of such collaboration is to identify SSIs by using automated inpatient and population-based ambulatory-care data, to characterize antibiotic-resistant pathogens, and to relate the rates of infection and antibiotic resistance to the appropriateness of preoperative antibiotic prophylaxis. A secondary goal is to assess and control other types of infection and, to the extent possible, extend this collaborative model to other types of problems. Although this approach was developed in a research-oriented HMO, it should be widely applicable in other settings and useful for a variety of other surveillance problems. Future activities under this agreement may include monitoring of other nosocomial infections, including neonatal infections and implanted central venous catheter infections.

Ultimately, these and similar collaborative efforts should serve as models for surveillance systems that work best when public health agencies and all of the participants involved in the care of individuals work together. These Harvard Pilgrim Health Care studies have proven that HMO data can help solve an existing problem—in this case, the inability to perform effective postdischarge surveillance for nosocomial infections—and can thereby reduce unnecessary efforts by hospital personnel.

LATTER DAY SAINTS HOSPITAL'S SYSTEM

Presented by John P. Burke, M.D.

Chief, Department of Clinical Epidemiology, Latter Day Saints Hospital, and Professor of Medicine, University of Utah School of Medicine

Experiences from the Latter Day Saints (LDS) Hospital in Salt Lake City, Utah, suggest that the best surveillance system operates in real time, providing



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