Page 210 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

208 Chapter 9
to contribute to enhanced preparedness, as demonstrated by the Platform for Preparedness for group A diseases. We show that indicators for timely response are disease specific and need to be chosen per event, preferably in consultation with the involved professionals.
Since timeframes for several interventions are not available in disease spe- cific guidelines as scientific evidence does not exist, further research in effective- ness of interventions related to time would facilitate public health authorities their decision process on interventions. Standardized data collection in HP Zone would enable research into timeframes for interventions in the Netherlands.
Timeframes in international frameworks for preparedness and response
Although timeliness in surveillance and response capacities is highlighted in as- sessment tools for public health preparedness by the WHO and the ECDC in their SPAR/JEE and HEPSA tool respectively, neither timeframes including per- formance indicators, nor standardized thresholds are incorporated (8, 26, 60). Next to capacity, which is defined as the ‘combination of all the strengths, at- tributes and resources available within an organization, community or society to manage and reduce disaster risks and strengthen resilience’, also the term capability has been introduced, which is the ‘possession of the demonstrable ability to perform a particular task’ (61). Capabilities show whether a system with certain capacities is able to achieve the intended goal to effectively identi- fy, characterize and respond to emergencies (62).
WHO also emphasizes the value of evaluating the functionality of IHR ca- pacities, and developed the monitoring and evaluation framework (63). This includes four components: next to the SPAR and JEE, also after action reviews (AAR) and simulation exercises (SimEx) are incorporated, which evaluate the actual functioning of capacities during a real-life event or an exercise. AAR is defined as a ‘qualitative review of actions taken to respond to an event’, by means of structured facilitated discussions. WHO distinguishes SPAR and JEE’s, quantitative assessments as they include a quantitative scoring system for the outcome, from AAR and SimEx, being qualitative components of their frame- work. While the first, analytical part, of an AAR involves development of a time- line from the start until the end of the outbreak including timeliness metrics, these are descriptive and not meant as process indicator (61, 64). Although par- ticipants are invited to evaluate the performance of core capacities including timely laboratory testing and availability of necessary supplies, no indication is given how determine the timeliness of these processes.