BackgroundThis work aims at providing practical recommendations for implementing automated surveillance (AS) of surgical site infections (SSI) in hospitals and surveillance networks. It also provides an overview of the steps, choices, and obstacles that need to be taken into consideration when implementing such surveillance. Hands-on experience with existing automated surveillance systems of SSI (AS SSI systems) in Denmark, France, the Netherlands and Spain is described regarding trend monitoring, benchmarking, quality control, and research for surveillance purposes.MethodsBetween April and October 2023, specific aspects/options of various surveillance purposes for AS SSI were identified during regular meetings of the SSI working group in the PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network. Expert discussions provided the basis for this perspective article.ResultsDecisions for implementation of AS SSI systems highly depend on the purpose of the surveillance. AS SSI systems presented here differ according to study population, setting, central or local implementation; the level of automation, design, and the data sources used. However, similarities were found for the rationales of automation, design principles and obstacles that were identified. There was consensus among all the experts that shortcomings in interoperability of databases, limited time, a want of commitment on the part of stakeholders, and a shortage of resources for information technology (IT) specialists represent the main obstacles for implementing AS SSI. To overcome obstacles, various solutions were reported, including training in the development of AS systems and the interpretation of AS SSI results, early consultation of end-users, and regular exchanges between management levels, IT departments, infection prevention and control (IPC) teams, and clinicians.ConclusionClarity on the intended application (e.g. purpose of surveillance) and information on the availability of electronic and structured data are crucial first steps necessary for guiding decisions on the design of AS systems. Adequate resources for IT specialists and regular communication between management, IT departments, IPC teams, and clinicians were identified as essential for successful implementation. This perspective article may be helpful for a wider implementation of more homogeneous AS SSI systems in Europe.
[1]Charite Univmed Berlin, Inst Hyg & Environm Med, Hindenburgdamm 27, D-12203 Berlin, Germany.
[2]Humboldt Univ, Hindenburgdamm 27, D-12203 Berlin, Germany.
[3]Berlin Inst Hlth, Hindenburgdamm 27, D-12203 Berlin, Germany.
[4]Charite Univmed Berlin, Natl Reference Ctr Surveillance Nosocomial Infect, Berlin, Germany.
[5]Assistance Publ Hop Paris, Ctr Prevent Healthcare Associated Infect, Paris, France.
[6]Natl Inst Publ Hlth & Environm, Ctr Infect Dis Control, Bilthoven, Netherlands.
[7]Univ Med Ctr Utrecht, Dept Med Microbiol & Infect Control, Utrecht, Netherlands.
[8]Bellvitge Univ Hosp, Dept Infect Dis, LHospitalet Llobregat, Barcelona, Spain.
[9]Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid 00009, Spain.
[10]Inst Invest Biomed Bellvitge IDIBELL, LHospitalet Llobregat, Spain.
[11]Staten Serum Inst, Dept Data Integrat & Anal, Copenhagen, Denmark.
[12]Regionernes Kliniske Kvalitetsudviklingsprogram, Aarhus, Denmark.
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