Page 227 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

specific. For some diseases, timeframes are provided for the effectiveness of the intervention, preferably evidence based, in the disease specific guidelines. Timeliness depends on the extent of steps and the involved stakeholders in the response chain, but also on the disease identification delay of the index. We showed that indicators for timely response are disease specific and need to be chosen per event, preferably in consultation with the involved professionals. Furthermore, when deciding on control measures, such as contact tracing of flight contacts, the delay in implementation and effect on effectiveness should be taken into account.
3. Timeframes in international preparedness and response frameworks
A monitoring and evaluation methodology is defined by the WHO to system- atically evaluate the functionality of IHR capacities. After action reviews (AAR) are developed as qualitative evaluation tool. Our studies show that quantitative evaluation of delays of public health response can demonstrate whether a mea- sure was implemented in an effective way in a certain event. This contributes to commitment among professionals and can function as catalyzer to come to improvements. We therefore recommend including quantitative performance indicators for evaluation of timeliness of response processes in the WHO AAR methodology.
Furthermore, quantitative assessments are facilitated by international standardization of thresholds for measuring timeliness of notifications systems according local timeframes. We recommend ≥ 80% timely notifications as suffi- cient, ≥ 50% up to 80% as partly sufficient and < 50% as insufficient.
4. Summary of elements facilitating effective preparedness for timely surveillance and response
a. Notification system, including legal aspects
A notification system which involves notifications by laboratories either com- bined with notifications by physicians or not, results in best timeliness of noti- fications to MHS. Electronic notification systems are not necessarily faster than conventional reporting methods. Setting legal and standardized timeframes for diseases facilitate timeliness of notifications.
b. Cooperation between stakeholders
MHS play an important role in notification systems, since they contribute to timely notifications through education and training of reporting health profes-
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