Surveillance of nosocomial infections: a fundamental ingredient for quality.

Nosocomial infections have been recognized for over a century as a critical problem affecting the quality of health care and a principal source of adverse healthcare outcomes. Today, nosocomial infections affect over 2 million patients annually in the United States, at a cost in excess of $4.5 billion.1 Among all major complications of hospitalization, nosocomial infections account for 50%; the remaining are medication errors, patient falls, and other noninfectious adverse events.2 A key tenet of the ongoing revolution in health care is the need to provide quality services while responsibly controlling costs. As fee-for-service reimbursement increasingly is replaced by capitated or other fixed-cost payments, dollars saved through prevention of nosocomial infections directly affect the financial well-being of healthcare institutions.1 Several articles in this issue of the journal remind us of the importance of surveillance of nosocomial infections and its place in assessing and improving the quality of medical care.