Browsing by Author "Silva, Andreia"
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- Avaliação das condições ambientais e de climatização das entidades prestadoras de cuidados de saúde do SNSPublication . Freitas, Maria da Graça; Soares, Ana paula; Santiago, Anabela; Silva, Andreia; Serrada, Elisabete; Diegues, Paulo; Almeida, Fernando de; Neto, Mariana; Direção-Geral da Saúde; Instituto Nacional de Saúde Doutor Ricardo JorgeApós a publicação da Orientação nº 13/2017 de 13 de julho, a Direção Geral da Saúde e o Instituto Nacional de Saúde Doutor Ricardo Jorge, em colaboração com as Administrações Regionais de Saúde, promoveram a avaliação das condições ambientais e de climatização das entidades prestadoras de cuidados de saúde (Cuidados de Saúde Primários e Cuidados de Saúde Hospitalares) do Serviço Nacional de Saúde, cujo resultado é apresentado no presente relatório.
- Challenging measles case definition: three measles outbreaks in three Health Regions of Portugal, February to April 2018Publication . Augusto, Gonçalo Figueiredo; Cruz, Diogo; Silva, Andreia; Pereira, Natália; Aguiar, Bárbara; Leça, Ana; Serrada, Elisabete; Valente, Paula; Fernandes, Teresa; Guerra, Fernando; Palminha, Paula; Vinagre, Elsa; Lopo, Sílvia; Cordeiro, Rita; Sáez-López, Emma; Neto, Maria; Nogueira, Paulo Jorge; Freitas, GraçaWe report three simultaneous measles outbreaks with 112 confirmed cases in three Health Regions of Portugal, from February to April 2018. The mean age of cases was 30 years, 79% worked in a healthcare setting and 87% were vaccinated. Genotype B3 was identified in 84 cases from the three outbreaks. Primary cases in each outbreak were imported. Several cases presented with modified measles, highlighting the importance of rethinking the measles case definition for vaccinated cases.
- Report of simultaneous measles outbreaks in two different health regions in Portugal, February to May 2017: lessons learnt and upcoming challengesPublication . Augusto, Gonçalo Figueiredo; Silva, Andreia; Pereira, Natália; Fernandes, Teresa; Leça, Ana; Valente, Paula; Calé, Etelvina; Aguiar, Bárbara Andreia; Martins, António; Palminha, Paula; Vinagre, Elsa; Cordeiro, Rita; Lopo, Sílvia; Nogueira, Paulo JorgeIn Portugal, measles vaccination coverage and population immunity are high, and no endemic measles cases had been reported since 2004. The World Health Organization classified measles as eliminated in the country in 2015 and 2016, based on data from the previous 3 years. However, in a context of increasing incidence in several European countries in 2016 and 2017, Portugal experienced two simultaneous measles outbreaks with a total of 27 laboratory-confirmed cases (0.3 cases/100,000 population) in two health regions between February and May 2017. Nineteen cases (70.1%) were adults, of whom 12 were healthcare workers. Overall, 17 cases (63.0%) were not vaccinated, of whom five were infants younger than 12 months of age. One unvaccinated teenager died. Genotype B3 was identified in 14 cases from both regions. Measles virus sequencing identified different possible origins of the virus in each region affected. Although measles transmission was stopped in less than 2 months from the first case being notified, these outbreaks represent an opportunity to reinforce awareness of measles diagnosis. We highlight the intensity of the control measures taken and their impact on the rapid control of the outbreaks and also the fact that high vaccination coverage was crucial to stop transmission.
- Surveillance in the time of austerity; Portuguese HIV/AIDS Surveillance achieves a 30% improvement in efficiency after LEAN inspired changes to processingPublication . Shivaji, Tara; Cortes Martins, Helena; Diniz, Antonio; Nogueira, Paulo J; Vasconcelos, Paula; Silva, AndreiaBackground In 2013, following reminders about statutory notification of HIV/AIDS, Portuguese clinicians notified all cases, irrespective of previous notification. At the same time, hospitals introduced electronic records that automatically generated additional paper notification reports. No supplemental resources were available to process the 10-fold increase in notifications. The ensuing backlog caused delays in providing timely information for HIV program planning and evaluation. We investigated whether management principles from the automobile industry (LEAN) could improve data management efficiency. Methods Efficiency was defined as the time spent processing the paper report into electronic surveillance information. We used value stream mapping to understand the process and employed focus groups to identify areas for improvement (LEAN methodology). We recorded the time taken to complete this process for randomly selected batches of reports and calculated the average time per report. Results When consulted, stakeholders expressed the need for information about recent HIV/AIDS diagnoses. We prioritized processing cases diagnosed between 2011-2013. We reduced data-entry errors and transcribing time by inserting drop-down menus and automatic variable calculators. We implemented auto-search during data entry to prevent duplication. We redesigned the data entry mask to match the paper report. Before intervention, processing time was 9 minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post-intervention, this was 6 minutes and 34 seconds (95% CI 6:25-6:43), reducing the time to process the remaining backlog (10,000 reports) by 54 days. Conclusion Applying LEAN techniques to HIV/AIDS surveillance in Portugal enabled delivery of crucial information to national and international HIV stakeholders through a 30% reduction in data processing time and optimization of data quality. Public health practitioners should consider LEAN techniques to improve data quality and efficiency of surveillance systems.