Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-12-01T02:00:35.963Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  21 June 2016

William E. Scheckler*
Affiliation:
St. Marys Hospital Medical Center and the University of Wisconsin-Madison Medical School Department of Family Medicine and Practice, Madison, Wisconsin
*
University of Wisconsin Medical School, Department of Family Medicine and Practice, 777 South Mills St., Madison, WI 53715

Extract

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.

Type
Beyond Infection Control: The New Hospital Epidemiology
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Williams, REO, Blowers, R, Garrod, LP, Shooter, RA. Hospital Infection: Causes and Prevention. 2nd ed. London: Lloyd-Luke Ltd.; 1966.Google Scholar
2. Bennett, JV, Brachman, PS, eds. Hospital Infections. Boston, Mass: Little, Brown and Company; 1979.Google Scholar
3. Goldmann, DA. Contemporary challenges for hospital epidemiology. Am J Med. 1991;91:8S15S.CrossRefGoogle ScholarPubMed
4. Decker, MD, Schaffner, W. Changing trends in infection control and hospital epidemiology. Infect Dis Clin North Am. 1989;3:671682.CrossRefGoogle ScholarPubMed
5. Ginzberg, E. Health care reform-why so slow? N Engl J Med. 1990;322:14641466.CrossRefGoogle ScholarPubMed
6. Deming, WE. Out of the Crisis. Cambridge, Mass: Massachusetts Institute of Technology, Center for Advanced Engineering Study; 1986.Google Scholar
7. Wenzel, RP, Dixon, RE, eds. Assessing Quality Care: The New Hospital Epidemiology. Baltimore, MD: Williams and Wilkins; 1991.Google Scholar
8. Decker, MD. Continuous quality improvement. Infect Control Hosp Epidemiol. 1992;13:165169.CrossRefGoogle ScholarPubMed
9. Decker, MD. The application of continuous quality improvement to healthcare. Infect Control Hosp Epidemiol 1992;13:226229.CrossRefGoogle Scholar
10. Berwick, DM. Continuous improvement as an ideal in health care . N Engl J Med. 1989;320:5356.CrossRefGoogle ScholarPubMed
11. Kritchevsky, SB, Simmons, BP Continuous quality improvement: concepts and applications for physician care. JAMA. 1991;266:18171823.CrossRefGoogle Scholar
12. Laffel, G, Blumenthal, D. The case for using industrial quality management science in health care organizations. JAMA. 1989;262:28692873.CrossRefGoogle ScholarPubMed
13. Berwick, DM, Godfrey, AB, Roessner, JJ. Curing Health Cure. San Francisco, Calif: Josey Bass Publisher; 1990.Google Scholar
14. Juran, JM. Planning for Quality. New York, NY: The Free Press; 1988.Google Scholar
15. Gross, PA, Beyt, E Jr Decker, MD, et al. Description of case-mix adjusters by the severity of illness working group of the Society of Hospital Epidemiologists of America (SHEA). Infect Control Hosp Epidemiol. 1988;9:309316.CrossRefGoogle Scholar
16. Stamm, WE, Weinstein, RA, Dixon, RE. Comparison of endemic and epidemic nosocomial infections. In: Dixon, RE, ed. Nosocomial Infections. New York, NY: Yorke Medical Books; 1981:913.Google ScholarPubMed
17. Scheckler, WE. Nosocomial infections in a community hospital: 1972 through 1976. Arch Intern Med. 1978;138:17921794.CrossRefGoogle Scholar