scholarly journals 18.H. Workshop: Bringing evidence during public health emergencies: addressing the challenge through HTA

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The process of including evidence in public health decision-making and for evidence-informed policy, in preparation, and during public health emergencies, is not systematic and is complicated by many barriers as the absences of shared tools and approaches for evidence-based preparedness and response planning. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability and to implement coordinated evidence-based response plans. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. As a multidisciplinary, standardized and evidence-based decision-making tool, Health Technology Assessment (HTA) represents and approach that can inform public health emergency preparedness and response planning processes; it can also provide meaningful insights on existing preparedness structures, working as bridge between scientists and decision-makers, easing knowledge transition and translation to ensure that evidence is effectively integrated into decision-making contexts. HTA can address the link between scientific evidence and decision-making in public health emergencies, and overcome the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines. It may allow a 360° perspective, providing a comprehensive view to decision-making in preparation and during public health emergencies. The objective of the workshop is to explore and present how HTA can be used as a shared and systematic evidence-based tool for Public Health Emergency Preparedness and Response, in order to enable stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. Key messages There are many barriers and no shared mechanisms to bring evidence in decision-making during public health emergencies. HTA can represent the tool to bring evidence-informed actions in public health emergency preparedness and response.

2015 ◽  
Vol 10 (1) ◽  
pp. 165-173 ◽  
Author(s):  
Harvey Kayman ◽  
Tea Logar

AbstractThree sets of issues tend to be overlooked in public health emergency preparedness and response, which can be addressed with new training protocols. The first issue is procedural and concerns the often intuitive (as opposed to deliberative) nature of effective crisis decision-making. The second issue is substantive and pertains to the incorporation and prioritization of ethical, political, and logistical concerns in public health emergency guidelines. The third issue is affective and concerns human feelings and human frailty, which can derail the most well designed and best practiced procedural and substantive approaches to emergency response. This article offers an outline for a decision-making framework for public health emergencies that addresses and incorporates these issues within relevant guidelines and training. (Disaster Med Public Health Preparedness. 2016;10:165–173)


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.


2013 ◽  
Vol 28 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Elena Savoia ◽  
Jessica Preston ◽  
Paul D. Biddinger

AbstractIntroductionThe objective of disaster preparedness is to ensure that appropriate systems, procedures, and resources are in place to provide prompt, effective assistance to disaster victims, thus facilitating relief measures and rehabilitation of services. Disaster preparedness efforts include the identification of possible health scenarios based on the probability of hazards and vulnerability of the population as a basis for creating a disaster plan. Exercises that simulate emergency response, involving the health and other sectors, have been suggested as useful tools to test the plans on a regular basis and measure preparedness efforts; the absence of actual testing is likely to negate even the best of abstract plans.ProblemExercises and after action reports (AARs) are used to document preparedness activities. However, to date, limited analysis has been performed on what makes an exercise an effective tool to assess public health emergency preparedness (PHEP), and how AARs can be developed and used to support PHEP improvement efforts. The scope of this project was to achieve consensus on: (1) what makes an exercise an effective tool to assess PHEP; and (2) what makes an AAR an effective tool to guide PHEP improvement efforts.MethodsSixty-one PHEP experts were convened by the use of Nominal Group Techniques to achieve consensus on a series of characteristics that exercises should have when designed to assess PHEP and on the recommendations for developing high-quality AARs.ResultsThe panelists achieved consensus on a list of recommendations to improve the use of exercises and AARs in PHEP improvement efforts. Such recommendations ranged from the characteristics of the exercise audience to the evaluation methodology being used and the characteristics of the produced AAR such as its structure and content.ConclusionsThe characteristics of the exercise audience, scenario and scope are among the most important attributes to the effectiveness of an exercise conducted for PHEP evaluation purposes. The evaluation instruments used to gather observations need an appropriate matching between exercise objectives and the response capabilities tested during the exercise, to build the base for the production of a good AAR. Improvements in the design and creation of exercises and AARs could facilitate better reporting and measurement of preparedness outcomes.SavoiaE, PrestonJ, BiddingerPD. A consensus process on the use of exercises and after action reports to assess and improve public health emergency preparedness and response. Prehosp Disaster Med. 2013;28(3):1-4.


Author(s):  
Rongxin He ◽  
Jun Zhang ◽  
Ying Mao ◽  
Olivier Degomme ◽  
Wei-Hong Zhang

This study aimed to descript the Belgian COVID-19 responses process according to the WHO’s (World Health Organization) Health Emergency and Disaster Risk Management Framework (Health EDRM Framework) and to present the measures taken and epidemic impact in the different phases of COVID-19 in Belgium. The WHO’s EDRM Framework was used for reviewing the Belgian Public health emergency preparedness and responses in the context of COVID-19. Information on the measures taken was collected through the literature review including all government’s communication, reports, and scientific papers. All epidemic data were extracted from a national open database managed and published by the Sciensano. Additionally, two authors closely followed the Belgian situation since the beginning of the pandemic and updated the data every day. During the COVID-19 pandemic, the anti-epidemic strategy was mainly to avoid medical resources exceeding the upper limit. Belgium issued a series of emergency decrees to limit the spread of the virus. An existing structure of “federal-region-municipal” as the framework of public health emergency preparedness and response was adapted. The emergency response process in Belgium was divided into four phases: information-evaluation-coordination-decision-making at the region level and the final decision-making at the federal level. Belgium also implemented a phased plan in the process of setting up and lifting the lockdown. However, it was vulnerable in early response, due to the shortage of medical equipment supplies in general, and more particularly for the long term care facilities (LTCFs). Belgium has achieved an intensive cooperation between stakeholders based on an existing multisectoral emergency organization framework. Legislation, medical insurance, and good communication also played a role in limiting the spread of viruses. However, the authorities underestimated the risk of an epidemic and did not take quarantine measures among people suspected affected by SARS-COV-2 in the early stages, resulting in insufficient medical equipment supply and a large number of deaths in the LTCF. The implementation of the lockdown measure in Belgium also encountered obstacles. The lockdown and its exit strategy were both closely related to the pandemic situation and social and economic life. The authorities should strengthen information management, improve the public awareness of the measures, and find out the balance points between the social and economic life and infection control measures.


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