Abstract The major impact of surveys of hospital infection has been the improvement in the quality of infection control programmes. The earlier surveys became an incentive to others to find out their infection rates and risk factors for infection. Surveys are now more sophisticated in design and the surveillance methods more refined, but they have had little impact on the rates of infection. Without doubt, the greatest improvements have been made by carrying out targeted surveillance with interpretive feedback to clinical staff. This has led to the use of guidelines for good practice and measures of outcome. This strategy has been shown to decrease infection rates, decrease the need for antibiotics therapy, alleviate morbidity and save on hospital costs.