Three decades of hospital epidemiology and the challenge of integrating Health Surveillance: reflections from a case study.

Abstract

This study proposes a reflection on the uses and future prospects of hospital-based health surveillance based on the account of a pioneering experience in hospital epidemiology, the epidemiology service at the Hospital Federal dos Servidores do Estado - HFSE, which served as the basis for the creation of epidemiologic surveillance units in municipal and state hospitals in Rio de Janeiro, Brazil. The epidemiology service has combined epidemiological surveillance, continuing education, in-service training, research, and health service evaluation since 1986. The service is part of the national epidemiological surveillance network and was responsible for the notification of 55,747 cases between 1986 and 2016, most of which were the result of active search. The integration of various levels of health surveillance and health care makes classical control activities more agile and provides instruments for measuring. The important role played by the service in human resources training is evident in the training of 1,835 medical interns and 78 residents up to 2016. In addition, this experience has served as the basis for the implantation of several other hospital epidemiological surveillance units. Current challenges include the promotion of effective communication and coordination among the other health surveillance committees.