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Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer ‐ the egg producing industry ‐ adopting “egg associated” outbreak investigation reports as the reference output. Defines and makes use of four primary performance indicators: accessibility of information; completeness of evidence supplied in food‐poisoning outbreak investigation reports as to the sources of infection in “egg‐associated” outbreaks; timeliness of information published; and utility of information and advice aimed at preventing or controlling food poisoning. Finds that quality expectations in each parameter measured are not met. Examines reasons why surveillance agencies have not delivered the quality demanded. Makes use of detailed case studies to illustrate inadequacies of current practice. Attributes failure to deliver “accessibility” to a lack of recognition on the status or nature of “consumers”, combined with a self‐maintenance motivation of the part of the surveillance agencies. Finds that failures to deliver “completeness” and “utility” may result from the same defects which give rise to the lack of “accessibility” in that, failing to recognize the consumers of a public service for what they are, the agencies feel no need to provide them with the data they require. The research indicates that self‐maintenance by scientific epidemiologists may introduce biases which when combined with a politically inspired need to transfer responsibility for food‐poisoning outbreaks, skew the conduct of investigations and their conclusions. Contends that this is compounded by serious and multiple inadequacies in the conduct of investigations, arising at least in part from the lack of training and relative inexperience of investigators, the whole conditioned by interdisciplinary rivalry between the professional groups staffing the different agencies. Finds that in addition failures to exploit or develop epidemiological technologies has affected the ability of investigators to resolve the uncertainties identified. Makes recommendations directed at improving the performance of the surveillance agencies which, if adopted will substantially enhance food poisoning control efforts.

This paper aims to describe the history and growth of mandatory public reporting of healthcare‐associated infection rates and the philosophy and implementation of an evidence‐based total‐quality‐oriented state government program and also to provide critical appraisal of recognized assumptions underlying this movement.

This paper provides a narrative review of pertinent evaluation research literature and the authors' own experience.

Washington is one of few states that hired experts in the subject area to develop its new program. It is one of the first exploring optimal ways to validate the rates reported, and one of very few taking evidence‐based approaches to all aspects of program design.

The work provides a model for less‐developed agencies to follow.

This is a new and unprecedented role for state health departments, but offers opportunities to raise standards of practice through continuous quality improvement approaches with hospital partners while regaining public trust through transparency. Weak evidence supporting fundamental assumptions, and failure of prior approaches, indicate that we must explore new paths rather than follow established ones.

The study aims to assess healthcare workers' needle‐stick injury (NSI) knowledge, attitudes and practices (KAP).

A cross‐sectional study was conducted in a 600‐bedded hospital throughout six months. The data were collected using an anonymous, self‐reporting questionnaire. Participants were various healthcare workers (HCW) drawn through stratified random sampling and their knowledge, attitude and practice regarding NSI were assessed.

There is significant difference in the mean knowledge, attitude and practice scores among healthcare workers. Even though scores are better for doctors and nurses, practice scores were better for technical staff. Healthcare workers, who had better practice scores, had suffered fewer NSIs. Since this study is a cross‐sectional, the population's NSI incidence could not be calculated.

This study emphasizes that applying knowledge to practice is required to prevent NSIs. Various recommendations to help prevent and deal with NSIs are made.

This study analyses healthcare workers' NSI knowledge, attitude and practices, and also assesses their correlation with NSI incidence, which has not been done previously.

This paper aims to describe the initial experiences in a new option of an established fellowship program, which can serve as a model that strengthens the next generation of our workforce for preventing healthcare‐associated infections.

Historical narrative.

The CSTE Applied Epidemiology Fellowship has a long history of success in producing future leaders for the public health workforce. As it expands into a healthcare‐associated infections option, it is addressing an area new to traditional public health departments. However, this also is an area where public health must be viewed as part of the continuum of healthcare systems, where tomorrow's professionals must be credible in a number of settings (health departments, hospitals, clinics and extended care facilities).

CSTE's first class of HAI Fellows offers a new model for producing the type of professionals necessary for the field of hospital epidemiology and infection control to achieve its full potential.

This is the first published description of the Council of State and Territorial Epidemiologists new Applied Epidemiology Fellowship “HAI” graduating class.

This chapter discusses the potential role of geographic information systems (GIS) for infection control within the hospital system. The chapter provides a brief overview of the role of GIS in public health and reviews current work applying these methods to the hospital setting. Finally, it outlines the potential opportunities and challenges for adapting GIS for use in the hospital setting for infection prevention. A targeted literature review is used to illustrate current use of GIS in the hospital setting. The discussion of complexity was compiled using the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework. Challenges and opportunities were then extracted from this exercise by the authors. There are multiple challenges to implementation of a Hospital GIS for infection prevention, mainly involving the domains of technology, organization, and adaptation. Use of a transdisciplinary approach can address many of these challenges. More research, specifically prospective, reproducible clinical trials, needs to be done to better assess the potential impact and effectiveness of a Hospital GIS in real-world settings. This chapter highlights a powerful but rarely used tool for infection prevention within the hospital. Given the importance of reducing hospital-acquired infection rates, it is vital to identify relevant methods from other fields that could be translated into the field of hospital epidemiology.

The paper aims to discuss discrepancies between recruiting representation versus workplace reality.

The approach is to provide a viewpoint of discrepancies between recruiting representation versus workplace reality.

All large organizations aspire to be recognized in a positive manner, but many might not truly appreciate the contrary signals broadcast by their responses to job applicants. Facing a well‐recognized global shortage of qualified individuals in most health care professions, hospital systems and public health agencies tend in job advertising to portray themselves as great places to work. However, their reply to applicants who respond can quickly dispel that illusion, driving away the sought after best and brightest who also just might tell their friends …

The paper provides a viewpoint of discrepancies between recruiting representation versus workplace reality.

Hospital physician shortages are widely recognized as a national problem in Japan. Although physician job satisfaction has a relationship with service quality and physician turnover, there is no measure to assess Japanese hospital physician satisfaction. This paper aims to establish a measure of job satisfaction for Japanese hospital physicians and evaluated its psychometric performance.

Two cross‐sectional physician surveys were used – a pilot survey, conducted as a self‐administered questionnaire; and a validation survey conducted on‐line.

A total of 82 hospital physicians completed the pilot questionnaire. Factor and reliability analyses produced a 28‐item, 6‐subscale and 2‐global satisfaction scale measure, the Japan hospital physicians satisfaction scale (JHPSS). Results supported the measure's reliability and validity. For the validation survey, 146 hospital physicians completed the online questionnaire. One question item was substituted following factor analysis. Results also displayed the measure's adequate psychometric properties.

Participating physicians were convenience samples, which may not fully represent Japanese hospital physicians.

The JHPSS, a brief questionnaire measuring Japanese hospital physician job satisfaction, should be useful for providing better quality care and improving our understanding of and ability to deal with Japanese hospital workforce issues.

Patient safety and medical error have become prominent issues following publication of Institute of Medicine reports in the USA. The USA, Australia, and now Canada have followed a national “medical error” studies path that uses language rejected by the interdisciplinary group of experts described previously in this column, and continues using methods considered seriously flawed as well as incomplete by noteworthy hospital epidemiologists. Preliminary review of British hospitals by similar methods also has been published. Proven and more cost‐effective surveillance methods are pertinent methods developed over the past several decades by hospital epidemiology and infection control professionals who have more experience, but this heritage has been ignored in recent patient safety juggernauts. It is time to question why retrospective physician chart review approaches remain in vogue with national bodies to enumerate adverse patient outcomes and attribute them with “medical error” when better alternatives exist.

This paper aims to briefly describe the increasingly complex array of organizations influencing American healthcare‐associated infection (HAI) prevention efforts during the modern era of infection control.

This paper is a narrative review.

The modern era of hospital infection control began in the 1950s, but received relatively little publicity until the dawn of the twenty‐first century. Since then, there has been a wave of unprecedented magnitude in individual state legislation mandates followed by a shift from state to federal agency activity. The resulting programs are in varying stages of development, ability, sustainability, and coordination.

Many government and healthcare entities are in uncharted territory with this new area of activity, facing challenges in having to coordinate work with many new and unfamiliar partners. Perspectives explored in this part of the Universities Council Symposium help by mapping out the various stakeholders in order to foster a research agenda through better understanding of powerful political players and their influence.

This is one of the first efforts to describe and map the evolving range of state and federal forces influencing hospitals' efforts to prevent healthcare‐associated infections.

This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization.

A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions.

This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met.

This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.