Leveraging electronic medical records for surveillance of surgical site infection in a total joint replacement population.

Objective: To evaluate whether a hybrid electronic screening algorithm using a total joint replacement (TJR) registry, electronic surgical site infection (SSI) screening, and electronic health record (EHR) review of SSI is sensitive and specific for SSI detection and reduces chart review volume for SSI surveillance.

Design: Validation study.

Setting: A large health maintenance organization (HMO) with 8.

An enhanced benchmark for prosthetic joint replacement infection rates.

Background: The National Nosocomial Infection Surveillance System (NNIS) has historically provided the infection control community with the most accurate benchmark for healthcare-associated infections. However, NNIS does not require postdischarge surveillance. For medical centers where comprehensive postdischarge surveillance is possible, the efficiency of surgical site infection (SSI) detection is enhanced and rates may be higher than those provided by NNIS.

Hand washing and physicians: how to get them together.

Objective: To determine the motivating and behavioral factors responsible for improving compliance with hand washing among physicians.

Design: Five unobtrusive, observational studies recording hand washing after direct patient contact, with study results reported to physicians.

Setting: A 450-bed hospital in a health maintenance organization with an 18-bed medical-surgical intensive care unit (ICU) and a 12-bed cardiac care unit.