Table 2. Proposed key interventions to strengthen hospital event-based surveillance system in Viet Nam based on the key findings from the qualitative study conducted in 2016.
| Overall recommendations | |||
|---|---|---|---|
| Develop a legal framework, guidelines and SOPs. | Promote feedback from the preventive medicine sector and communication within the curative sector. | Streamline preventive medicine laboratory services to support signal detection and timely reporting. | Build technical capacity in signal detection, reporting and response through training and on-the-job coaching during monitoring visits. |
| Proposed key interventions | |||
|---|---|---|---|
|
Develop clear guidelines and SOPs for both hospital internal reporting and reporting to PMCs. Engage DOH in encouraging collaboration between the curative and preventive medicine sectors. Review and identify opportunities to improve existing guidelines and SOPs for the preventive medicine sector. Improve current feedback reporting template and procedure in the preventive medicine sector to promote two-way communication with the curative sector. Pilot-test guidelines and SOPs in selected provinces to inform the development and implementation of the national EBS guidelines in Viet Nam. |
Strengthen and implement regular feedback reporting from the preventive medicine sector to the curative sector to demonstrate how reported data are used and to inform disease trends in the locality. Promote a close relationship and communication between the two sectors by assigning a dedicated focal person and backup focal persons at the hospital (responsible for reporting) and at the PMC (responsible for receiving and responding to reports). Encourage regular sharing of information on unusual cases in hospitals to identify clusters within the hospital in a timely manner, including during morning meetings, through local e-mail networks or by phone. |
Streamline preventive medicine laboratory services, including defining their roles of referring specimens through their preventive medicine laboratory networks, and clarify their roles to health-care workers. Review laboratory result feedback systems and identify ways to increase turnaround time to incentivize medical practitioners to send specimens for diagnostic confirmation. Encourage a proactive follow-up of laboratory results and feedback. Identify ways for preventive medicine laboratories to provide regular updates to the hospitals regarding existing and new services available and feasible turnaround times. Review existing signals to be reported by the laboratory to increase the sensitivity of signal detection at the hospital laboratories. |
Conduct training and refresher training for hospital and laboratory staff to sensitize them on the concepts of EBS, list of potential signals and reporting procedures. Include senior leadership in the training for hospital staff to encourage direct and timely reporting. Train surveillance staff in the preventive medicine sector on SOPs and epidemiological analysis to improve data analysis skills, and provide technical support as needed to PPMC to generate feedback reports. Implement periodic monitoring to provide on-the-job coaching to staff to increase their technical capacity in signal detection and reporting at the hospitals. Conduct additional monitoring visits and on-the-job coaching at hospitals and PMCs for rural areas and industrial zones. |
DOH, Department of Health; EBS, event-based surveillance system; PMC, preventive medicine centre; PPMC, Provincial Preventive Medicine Centre; SOP, standard operating procedure.