Methodology - Surveillance Evaluation
Routine audits of the reporting clinical laboratories are a requirement of ABCs surveillance. The purpose of the audit is to ensure that all cases of disease under surveillance are being captured in the ABCs system.
Audits of all clinical laboratories are required a minimum of once a year. The primary data source at every reporting site (e.g., laboratory log slips/log book, computer-generated electronic printouts) should be reviewed for all organisms under surveillance compared to the list of cases that were reported to the surveillance personnel. A case report form is completed on all newly identified cases and isolates collected when available.
In addition to a site's annual audit, every 2-3 years, each site performs an evaluation of their overall surveillance methodologies to ensure they are capturing all cases of invasive disease in catchment area residents for each pathogen under surveillance. This includes identifying laboratories located both within and outside of the ABCs catchment area that process specimens from residents of an ABCs site as well as identifying facilities and/or state/local health departments that serve residents of the catchment area. Routine communication with each laboratory and facility/health department that contributes to ABCs cases is needed to ensure that ongoing surveillance is active- and population-based surveillance.
The following surveillance indicators are used to assess ABCs: the percentage of isolates collected and sent to CDC, the percentage of cases enrolled in special studies nested within the surveillance system, the timeliness of scheduled isolate shipments, and the timeliness and sensitivities of completed audit data. The timeliness and completeness of reporting in ABCs is evaluated using threshold percentages of isolate collection and enrollment into special studies. Surveillance "fatigue" or operational problems are assessed using isolate shipping schedules, audit sensitivities, and the timeliness of the audit data being completed by set deadlines.
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