Surveillance strategies: a primer.

A variety of acceptable surveillance methodologies have been described. CDC-type surveillance remains the standard, but a limited program may be most sensible for some. Surveillance by objective is an attractive concept and reports of its value are anticipated. For some, laboratory-based systems for identifying nosocomial infections and outbreaks have been highly effective but chart review is often still necessary. Regardless of the surveillance method chosen to anchor a program, the program should be flexible and dynamic, not static. Institutional needs should be assessed continually and the program should change as the problems change. Different strategies may be optimal at different times, and indeed many surveillance programs use a combination of elements. In our view adaptability and flexibility within a well-defined framework are qualities that improve not only responsiveness but also effectiveness.