The Minister of Health, Mr. Jean-François MATTEI, referred the matter to the French Institute for Public Health Surveillance (InVS) in March 2003 (Appendix 1) to establish indicators for combating healthcare-associated infections that could serve as a performance dashboard for all public and private healthcare facilities. After noting the significant efforts made in France to combat nosocomial infections, the request states that such infections remain too frequent, particularly those linked to multidrug-resistant bacteria. The development of these surveillance dashboards at the level of each healthcare facility should make it possible to track progress, adapt efforts and resources, and inform patients. To this end, the referral states that it is necessary to have responsive continuous surveillance tools in French healthcare facilities that should: - focus on significant infections: reflecting the quality of care and prevention efforts, affecting prognosis, and detectable by laboratory testing or simple clinical criteria; - allow for comparisons within a facility and help position it relative to others. This surveillance should be extended to all healthcare facilities, implemented gradually, and designed within the framework of a dashboard that may include other indicators: resources allocated, antibiotic consumption, and bacterial resistance to antibiotics. This referral indicates the Minister of Health’s intention to supplement the current surveillance system with a facility-level surveillance tier. It should be noted that the current system is organized on an interregional basis, led by the C.CLINs and coordinated at the national level by the InVS within the network for the alert, investigation, and surveillance of nosocomial infections (RAISIN). Each facility participates in the networks on a voluntary basis and has access to its own results; however, the CCLIN analyzes the results in aggregate. The current nosocomial infection surveillance system relies on the following tools: 1) prevalence surveys, 2) voluntary incidence surveillance networks, and 3) reporting of nosocomial infections as defined by regulations. The system to be defined must be continuous and comprehensive (covering all facilities at all times), have a strong link to the quality of care and prevention, and, in addition to enabling a facility to track its performance over time, must allow for comparisons between facilities. Designed to take the form of a dashboard, its new purpose is to provide information to users at the level of each facility, although the specific format of this user information has not been specified (dashboard available upon request or displayed). (R.A.)