Continuous Quality Improvement in a Hospital System: Implications for Hospital Epidemiology

Abstract

The purpose of this report is to describe the “Continuous Quality Improvement” (CQI) paradigm as adopted by one of the 30 largest hospital systems in the United States and to explore the implications for hospital epidemiology and infection control. Hospital epidemiology has its roots in the application of epidemiologic tools and principles to the problems of nosocomial infections. Key steps in the development of hospital epidemiology came from physicians in Great Britain and the United States who were part of the public health systems of those countries. In the United States, physicians trained in infectious diseases as a subspecialty occupy the position of hospital epidemiologist in most university, Veterans Affairs, and larger community teaching hospitals. Some of these individuals argue that hospital epidemiologists should continue to focus principally on infection control. Others are just as convinced that the premises and knowledge of epidemiology honed by experiences in infection control are very well suited to many other problems facing hospitals in the 1990s.