Over 2,500 health care professionals from the United States and fifty-five other nations met in Atlanta, Georgia March 5-9 for the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections. The Decennial Conference, sponsored every 10 years by the Centers for Disease Control and Prevention (CDC), helps to set the agenda for infection research and control efforts in the next decade. Specifically, the 4th Decennial was designed to establish direction in infection control and healthcare epidemiology for the beginning of the next millennium.

In her welcome address, Julie Gerberding, MD, director of the Hospital Infections Program at the CDC and conference chair, outlined the three major change drivers for infection prevention and control beyond the year 2000: healthcare financing and value, healthcare system complexity, and information technology. Dr. Gerberding emphasized that infection control professionals need to be able to measure infection control value and develop an evidence base that can contribute to patient care quality and value. She went on to say that the information presented at this year's conference was designed to help lay the foundation for future progress in infection control.

"It is time for us to rethink our vocabulary and work to promote quality," stated Dr. Gerberding. She continued, "terms like nosocomial, surveillance, and quality assurance need to be replaced by new terms like 'quality promotion' so that everyone can work with together. We also need to prioritize problems for actions, promote the cycle of success, continue developing an evidence-based research agenda and continue sharing the lessons we have learned." Citing the recently published report To Err is Human by the Institute of Medicine (IOM), Dr. Gerberding emphasized that infection control professionals need to be able to measure infection control value and develop an evidence base that can contribute to patient care quality and value.

Apparently many of the surveillance and prevention programs implemented since the 3rd Decennial Conference in 1990 are leading to a decrease in infection rates. A report published in Morbidity and Mortality Weekly Report (MMWR) on March 3, 2000 shows a significant decrease in nosocomial infection rates in the US, particularly, bloodstream infections, due to hospital participation in the National Nosocomial Infections Surveillance System (NNIS). NNIS is a voluntary, hospital-based nosocomial infection reporting system which is comprised of 285 hospitals in 42 states.

The keynote address, delivered by John Eisenberg, MD, MBA, director, Agency for Healthcare Research and Quality (AHRQ), also cited the IOM report in an address that focused on the need for non-punitive systems that would address patient safety without blaming or shaming the healthcare industry. Citing the report, Dr. Eisenberg noted that preventable medical errors account for as many as 98,000 deaths in the US, the fifth leading cause of death for Americans. Dr. Eisenberg emphasized that infection control is part of the solution to this problem. He also cited the NNIS system as an excellent model for addressing adverse events other than infections.

Dr. Eisenberg outlined the elements that make NNIS a successful model for all reporting systems: clear definitions, standardized method for surveillance, a feedback system that works, including risk adjustment for data, and data that is really used to improve performance -- not to blame outliers.

The sessions for the 4th Decennial Conference were organized into three tracts: Prevention is Primary, State-of-the-Art, and Bench to Bedside and Beyond. There were also slide presentations and audience response sessions entitled, Reality Check. In addition, the conference had an exhibit area where infection control specialists could garner information about the latest products in infection control.

The 4th Decennial Conference was co-sponsored by the Association for Professionals in Infection Control and Epidemiology (APIC), National Foundation for Infectious Diseases (NFID), and the Society for Healthcare Epidemiology of America (SHEA) in conjunction with the 10th Annual Meeting of SHEA.