Implementing control measures.

Implementation is the means by which a favorable infection control policy leads to a favorable result (low infection rate). Determination of endemic infection rates by traditional surveillance (outcome surveillance) may, in many situations, be a relatively insensitive method for identifying suboptimal implementation practices. Surveillance of the practices themselves (process surveillance) may identify situations likely to lead to unfavorable results and thus provide early feedback to personnel. Innovative approaches to process surveillance are needed in order to enhance motivation.