15 research outputs found

    Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

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    Introduction: Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods: We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results: We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions: We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings

    Reassuring and managing patients with concerns about swine flu: Qualitative interviews with callers to NHS Direct

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    <p>Abstract</p> <p>Background</p> <p>During the early stages of the 2009 swine flu (influenza H1N1) outbreak, the large majority of patients who contacted the health services about the illness did not have it. In the UK, the NHS Direct telephone service was used by many of these patients. We used qualitative interviews to identify the main reasons why people approached NHS Direct with concerns about swine flu and to identify aspects of their contact which were reassuring, using a framework approach.</p> <p>Methods</p> <p>33 patients participated in semi-structured interviews. All patients had telephoned NHS Direct between 11 and 14 May with concerns about swine flu and had been assessed as being unlikely to have the illness.</p> <p>Results</p> <p>Reasons for seeking advice about swine flu included: the presence of unexpectedly severe flu-like symptoms; uncertainties about how one can catch swine flu; concern about giving it to others; pressure from friends or employers; and seeking 'peace of mind.' Most participants found speaking to NHS Direct reassuring or useful. Helpful aspects included: having swine flu ruled out; receiving an alternative explanation for symptoms; clarification on how swine flu is transmitted; and the perceived credibility of NHS Direct. No-one reported anything that had increased their anxiety and only one participant subsequently sought additional advice about swine flu from elsewhere.</p> <p>Conclusions</p> <p>Future major incidents involving other forms of chemical, biological or radiological hazards may also cause large numbers of unexposed people to seek health advice. Our data suggest that providing telephone triage and information is helpful in such instances, particularly where advice can be given via a trusted, pre-existing service.</p

    Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe: the added value of syndromic surveillance

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    BACKGROUND: The revised World Health Organization's International Health Regulations (2005) request a timely and all-hazard approach towards surveillance, especially at the subnational level. We discuss three questions of syndromic surveillance application in the European context for assessing public health emergencies of international concern: (i) can syndromic surveillance support countries, especially the subnational level, to meet the International Health Regulations (2005) core surveillance capacity requirements, (ii) are European syndromic surveillance systems comparable to enable cross-border surveillance, and (iii) at which administrative level should syndromic surveillance best be applied? DISCUSSION: Despite the ongoing criticism on the usefulness of syndromic surveillance which is related to its clinically nonspecific output, we demonstrate that it was a suitable supplement for timely assessment of the impact of three different public health emergencies affecting Europe. Subnational syndromic surveillance analysis in some cases proved to be of advantage for detecting an event earlier compared to national level analysis. However, in many cases, syndromic surveillance did not detect local events with only a small number of cases. The European Commission envisions comparability of surveillance output to enable cross-border surveillance. Evaluated against European infectious disease case definitions, syndromic surveillance can contribute to identify cases that might fulfil the clinical case definition but the approach is too unspecific to comply to complete clinical definitions. Syndromic surveillance results still seem feasible for comparable cross-border surveillance as similarly defined syndromes are analysed. We suggest a new model of implementing syndromic surveillance at the subnational level. In this model, syndromic surveillance systems are fine-tuned to their local context and integrated into the existing subnational surveillance and reporting structure. By enhancing population coverage, events covering several jurisdictions can be identified at higher levels. However, the setup of decentralised and locally adjusted syndromic surveillance systems is more complex compared to the setup of one national or local system. SUMMARY: We conclude that syndromic surveillance if implemented with large population coverage at the subnational level can help detect and assess the local and regional effect of different types of public health emergencies in a timely manner as required by the International Health Regulations (2005)

    Aplicação sistêmica do modo de análise de falhas e efeitos (FMEA) para o desenvolvimento de indicadores de desempenho de empresas de pequeno porte Systemic application of the failure method evaluation analysis (FMEA) for the development of performance indices on small size enterprises

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    O setor florestal brasileiro emprega direta e indiretamente 6,5 milhões de pessoas, e, dessas, 2,5 milhões estão empregadas no subsetor de madeira processada mecanicamente. O parque industrial voltado à produção de madeira serrada dispõe de aproximadamente 10.000 unidades, predominando as empresas de pequeno porte, das quais 74,6% têm capacidade instalada menor que 10.000 m³/ano e 24,7% entre 10.000 e 30.000 m³/ano. As empresas de pequeno porte caracterizam-se por apresentar baixo nível tecnológico, mão de obra pouco especializada e dificuldade de estabelecer itens de controle que possibilitem o gerenciamento eficaz do processo produtivo. Considerando a importância socioeconômica e as dificuldades gerenciais e os benefícios que um sistema de medição de desempenho pode trazer para as pequenas e médias empresas, este trabalho teve como objetivo identificar os fatores críticos do processo de produção de esquadrias de madeira em uma empresa de pequeno porte. Para isso, utilizou-se a metodologia análise do modo de falhas e seus efeitos (FMEA), para identificação das falhas potenciais, e a partir delas desenvolver indicadores de desempenho. Foram identificados 24 modos de falha, e todos foram considerados críticos, sendo analisados e monitorados, observando-se que existe potencial de melhoria no processo analisado.<br>The Brazilian forestry sector employs directly and indirectly 6,5 millions of people. There are, out of these, 2,5 million allocated in the mechanized processed wood sub sector. The industrial park, for the production of sawn wood, has approximately 10.000 units. Most of them are small size enterprises and 74,6% of them have less than 10.000 m³ year-1 of installed capacity. The small size enterprises are present low technology level, workers with poor qualification and difficulties of establishing control items which allow the efficient management of the productive process. Considering their social and economical importance, the managing difficulties of small and medium size enterprises and the use of indices of critical performance in order to improve the management system, this work aims at defining the indices of critical performance of the production process of small size enterprises in wood business. For such, the FMEA methodology was used to identify the potential failures and, as a result, to develop the performance indices. There were 24 types of failure identified, all of them considered as critical. They were analyzed and monitored. It was observed that there is a potential to improve the process

    Proposta de um sistema de avaliação do desempenho para arranjos produtivos locais Purpose of a performance measurement system for an industrial cluster

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    Os Arranjos Produtivos Locais (APLs) são sistemas que podem ser utilizados para promover a cooperação empresarial, a inovação contínua e o desenvolvimento sustentável das Pequenas e Médias Empresas (PMEs). O processo de gestão de desempenho do APL é construído a partir do planejamento estratégico e com a implantação de ações coletivas de melhoria contínua. Também é necessário construir uma infraestrutura local e um ambiente que estimule a confiança e a cooperação dos membros do APL. A avaliação de desempenho é uma prática que fortalecerá a coordenação e execução das atividades de melhoria contínua do APL. Assim, o objetivo deste trabalho é propor um Sistema de Medição do Desempenho (SMD) que dê suporte ao processo de gestão de desempenho do APL. A proposta foi construída a partir das pesquisas de campo realizadas nos APLs de Ibitinga e Jaú. Os resultados demonstram que a medição de desempenho integrada a um processo sistemático de melhoria contínua promove a gestão colaborativa, aprimora o processo de tomada de decisão ou coordenação das ações planejadas pelas instituições, empresas e outros órgãos que fazem parte dos APLs. É um instrumento que pode ajudar a monitorar o desempenho das PMEs inseridas em uma rede de cooperação empresarial e direcionar as iniciativas coletivas ou ações de melhoria para as principais necessidades do APL.<br>Industrial clusters or cooperation network is an interesting alternative in promoting the sustainable development of Small and Medium Enterprises (SME's). The fundamental characteristics for managing the performance of clusters are the identification of the stakeholders, definitions of common strategies and objectives, development of collaborative improvement actions, design of a performance management system, organization of a support infrastructure, and promotion of social capital. The concepts of a performance management system can be of great value in managing collective efficiency and performance improvement of the companies of the cluster. The purpose of this article is to describe a model for the performance measurement and management of a cluster. In order to develop this study, a field research was carried out in two industrial clusters: Ibitinga, a textile industry cluster and Jau, a Lady's footwear cluster. The results show the applicability of performance measurement systems for the performance management of a cluster. It also helps to integrate the objectives of performance establishing actions, evaluating results promoting cooperation to improve the collective efficiency of a cluster
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