This is an Entry to the Government Best Practice Recognition Awards
Hospital Epidemiology and Surveillance Unit (HESU)
Dr. Jose N. Rodriguez Memorial Hospital
Best practice Focus Area(s)
Process Management and Improvement
The best practice is the integration of a surveillance system in the institution capable of detecting, reporting, and responding to health threats in close collaboration with external stakeholders. The distinct feature of this is the identification of a framework that consolidates the enormous national health programs implemented by the Department of Health (DOH) into one functional and sustained program even before the published guidelines by DOH. This has been a reference to the scope and coverage of hospital surveillance systems being developed by the Epidemiology Bureau. Surveillance was practiced since 2009 but was refined and formally introduced in the institution in 2016.
Background and Problem
The objective of this program is to create and institutionalize an internal mechanism for early detection and response of public health events—which have potential threats—captured by the institution and maintain a close collaboration with its external counterparts to deliver an immediate epidemiologic response.
Though this program started in 2009, its performance to ensure sustenance to DOH endeavors was inconsistent. There was no hospital unit or entity in which this program was identified to coexist; hence, authority to be recognized and compiled across all levels in the hospital was not evident. Only the surveillance team, trained by the DOH who recognizes the importance, was compelled to execute despite all limitations. The challenge requires that a similar system should be adopted in healthcare facilities where public health threats on diseases abound and that gaps encountered in this model should be addressed in its implementing rules and regulations.
Solution and Impact
The best practice started after the framework of surveillance had been created. The design of the reporting unit was based on the consolidation of different reportorial requirements mandated by the DOH as well as of similar units in other countries. From the identification of the framework, minimum operational standards including the need for space and workforce was then identified. Initial guidelines and protocols were drafted and presented to the director. The establishment has provided an identified unit where community-acquired and hospital-acquired infections will be monitored, reported, and responded. This function is in great coordination with the national and local levels. After being formalized, the main idea to ensure the sustenance of the surveillance activities is the good representation of all hospital areas.
Surveillance officers were trained on the different programs under this. Though one challenge is the lack of full-time employees, it did not hamper in executing program functions which established the distinct identity of HESU. Recently, this primary source of information had provided the necessary action during the recently declared Measles and Dengue outbreak in 2019. Long term impact will include a constant collaboration with external stakeholders for ensuring a timely response on any health event.
Upon establishment and concerted efforts on its implementation in the hospital, the champions of this program closely collaborated with the national health department for the creation of a uniform surveillance system. Following meetings, consultations, and presentations, the mandate for supporting this program was signed and circulated.
The establishment of the surveillance system was recognized by the Philippine Hospital Association as highlights of a special award in the Best Hospital Infection Prevention and Control Years IV (2017) and Year V (2018) respectively as “Best in Outbreak Prevention and Management”. It was also showcased during a symposium of the Field Epidemiology Training Program Annual Scientific Conference with the theme “30 Years of Disease Surveillance” in 2018.