Page 26 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

24 Chapter 1
In the Netherlands, the Health Inspectorate has delegated the monitoring of timeliness of reporting to the RIVM, indicating that ideally all reports (100%) from MHS to the RIVM (D6) are timely (50). The RIVM uses 80% as threshold in the 4-monthly feedback to MHS. Below this threshold, timeliness is considered not sufficient and reasons for the low scores are assessed and recommenda- tions for improvement are made and followed up. In 2014, all MHS reported over 90% of their cases in time to the RIVM (51).
Timeliness of response
Response is defined as ‘the provision of emergency services and public assis- tance during or immediately after a crisis, in order to save lives, to reduce im- pacts on health, environment and society, ensure public safety and meet the basic subsistence needs of the people affected’ (26).
Timeliness of response is ‘the time between detection of an event and ini- tiation of a recommended response’ and systematic evaluations of response, including timeliness, forms one of the indicators for an established and func- tioning public health emergency response system according the WHO IHR Core capacity monitoring framework (52). Another indicator is timely information and guidance about an event provided to health and other professionals, in the HEPSA tool from the ECDC (26).
Performance indicators for evaluation of timeliness of response are also scarce, however. Timeliness for post exposure interventions for individual con- tacts are available in disease specific guidelines, for example vaccination or pro- vision of antibodies for varicella, measles and rabies (53). Timeliness defining the quality of the response capacity is less well defined. Response systems differ between countries and health systems. In the Dutch response system, an Out- break Management Team (OMT) can be convened within 24 hours, to assess an event and provide technical advice on the response. In 2007 for example, an OMT concluded within 24 hours that a causal relationship between vaccination and the death of 4 Dutch persons after seasonal vaccination was very unlikely and that campaign did not need to be interrupted (54). The IHR states that a State Party should notify within 24 hours of assessment an event that may con- stitute a public health event of international concern (4). WHO’s SPAR refers to timeliness in the indicator ’C9 Health care provision’; access to health services is defined as ‘the timely use of health services to achieve the best health out- comes’, involving amongst others: gaining entry into the health care system, and getting access to sites of care where patients can receive required services (19). The ECDC HEPSA tool considers timeliness as asset for countermeasures,