How to Evaluate Public Health Surveillance Systems

Public health surveillance systems are the watchdogs of public health departments. They keep an eye on threats with a goal of trying to prevent outbreaks of disease. Surveillance means routinely scanning for signs about the spread of disease. It is important to know how well these systems work so that changes can be made, if needed, to make sure that possible outbreaks are detected early enough to be stopped.

Instructions

Establish Baseline Information

• 1

  Document the purpose of the system you are evaluating. Surveillance systems are built to address different needs, and these should be taken into account.

• 2

  Identify key stakeholders. Without cooperation and collaboration from the people who hold the information, surveillance systems can't work. It is important to identify weak links in the information flow.

• 3

  Create a map of system operations. It is critical to map out exactly how the surveillance system is designed in order to identify strengths and weaknesses in the program.

Measure Performance

• 4

  Measure timeliness: Did the system capture disease information soon enough to prevent an outbreak? Measuring time between exposure to a disease or early symptoms and action at a public health level is the key to effective disease detection. Information about detection of outbreaks is the core of the evaluation. This is where past experience can help inform improvements.

• 5

  Evaluate validity of the information gathered. While it is important to intercept disease outbreaks early, it is not good to "cry wolf" and call every blip on the radar an outbreak. A good evaluation checks that the public health data and response are based on valid, credible information.

• 6

  Assess the usefulness of the surveillance system. Does the system produce timely, valid information that is acted on by key stakeholders? Only information that leads to improvements in practice or behavior is useful.

• 7

  Evaluate the flexibility of the system. Is the system flexible enough to adapt to new sources of information, new types of disease patterns or other changes?

• 8

  Poll users as to acceptability of the system. Is the system user-friendly or does it require the health department to beg for information? It is important that surveillance systems be realistic in addition to being effective at detecting disease.

• 9

  Assess the stability of the surveillance program. Is the system based on a very old software model? Are there frequent system shut-downs or glitches?

• 10

  Evaluate the costs of the program. Is the system cost worth the output and efficiency?

Summarize What You Found

• 11

  Summarize the key findings from the evaluation and draw conclusions about the effectiveness of the system.

• 12

  Generate recommendations for changes or improvements. Often these recommendations will be incorporated into ongoing strategic planning and budgeting exercises by the public health department.

• 13

  Create a concise executive summary that provides the key conclusions and recommendations for stakeholders who do not want to read the full report.