Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality.

Background: Healthcare systems aim to enhance the health status and well-being of the individuals and populations they serve. To achieve this, measuring and evaluating the quality and safety of services provided and the outcomes achieved is essential. Like other countries, Romania faces challenges regarding the quality of care provided in its public hospitals.

The effect of sampling frequency and spatial and temporal variation in the density of fecal indicator bacteria on the assessment of coastal bathing water quality.

The time and location of sampling as well as the number of samples per season can influence a reliable assessment of bathing water quality. In this study, we investigated the spatio-temporal variation of fecal indicator bacteria (FIB) density and the effects of FIB variability and sampling frequency on the assessment of a single sample and the annual and final assessment of coastal bathing water quality. Increasing the number of samples from 10 to 20 per bathing season had a significant impact on bathing water quality assessment at sites where water quality fluctuations had previously been observed, resulting in a change in water quality to a lower category in 36 % of annual and 54 % of final assessments, suggesting that the minimum number of samples per season should be increased at such sites.

Assessment of the eutrophication status at Mediterranean sub-basin scale, within the European Marine Strategy Framework Directive.

The aim of this work is to define harmonized reference conditions and assessment thresholds for selected criteria elements of the Marine Strategy Framework Directive (MSFD) Descriptor 5 (Eutrophication) in the Eastern Mediterranean Sea and to test if a tool for integrated assessment of the status of marine systems can be used as a common methodological approach. In this frame, we tested two statistical approaches in order to set threshold values for four criteria of Descriptor 5: nutrients, chlorophyll a, transparency and dissolved oxygen in the bottom waters. It is noteworthy that this work revealed the need to apply common procedures in data treatment and assessment evaluation.

Health system performance assessment: embedding resilience through performance intelligence.

Health systems around the world are facing challenges in achieving their goals. In the wake of the coronavirus disease pandemic, the need for resilient health systems has become even more apparent. This article argues that embedding resilience into health system performance assessment (HSPA) frameworks can be a valuable approach for improving health system performance.

Data-Driven Collaboration between Hospitals and Other Healthcare Organisations in Europe During the COVID-19 Pandemic: An Explanatory Sequential Mixed-Methods Study among Mid-Level Hospital Managers.

Introduction: Data and digital infrastructure drive collaboration and help develop integrated healthcare systems and services. COVID-19 induced changes to collaboration between healthcare organisations, which previously often happened in fragmented and competitive ways. New collaborative practices relied on data and were crucial in managing coordinated responses to the pandemic.

Use of Performance Data by Mid-Level Hospital Managers in Ontario: Results of a Province-Wide Survey and a Comparison with Hospital Managers in Europe.

This paper provides insights into the use of performance data by middle managerial staff in Ontario hospitals in 2019 and compares the results to a study conducted in Europe in the same year. A total of 236 managers working in 61 hospitals across Ontario provided responses to the survey. Compared to their European colleagues, Ontario respondents self-assessed using significantly more performance data for managerial decision making.

Status of the health information system in Ireland and its fitness to support health system performance assessment: a multimethod assessment based on stakeholder involvement.

Background: Between 2019 and 2021, the first Irish health system performance assessment (HSPA) framework was developed. As routinely collected health data are necessary to continuously populate indicators of an HSPA framework, a purpose-driven assessment of the health information system (HIS) in Ireland and its fitness to support the implementation of an HSPA framework was conducted. This study reports on the status of the Irish HIS through a multimethod assessment based on continuous broad stakeholder involvement.

The experiences of 33 national COVID-19 dashboard teams during the first year of the pandemic in the World Health Organization European Region: A qualitative study.

Background: Governments across the World Health Organization (WHO) European Region have prioritised dashboards for reporting COVID-19 data. The ubiquitous use of dashboards for public reporting is a novel phenomenon.

Objective: This study explores the development of COVID-19 dashboards during the first year of the pandemic and identifies common barriers, enablers and lessons from the experiences of teams responsible for their development.

Enablers and barriers to the secondary use of health data in Europe: general data protection regulation perspective.

Background: The General Data Protection Regulation is a regulation in EU law on data protection and privacy in the European Union. We aimed to provide an overview of the General Data Protection Regulation (GDPR) enablers and barriers to the secondary use of health data in Europe from the research we conducted in the Joint Action InfAct (Information for Action!) WP10 Assessing and piloting interoperability for public health policy, as well as to provide an example of a national-level case study on experiences with secondary use of health data and GDPR on an example of the Austrian COVID-19 data platform.

Methods: We have identified a number of European initiatives, projects and organizations that have dealt with cross-border health data sharing, linkage and management by desk research and we conducted 17 semi-structured in-depth interviews and analyzed the interview transcripts by framework analysis.

Engaging citizens in the development of a health system performance assessment framework: a case study in Ireland.

Background: The launch in 2017 of the Irish 10-year reform programme Sláintecare represents a key commitment in the future of the health system. An important component of the programme was the development of a health system performance assessment (HSPA) framework. In 2019, the Department of Health of Ireland (DoH) and Health Service Executive (HSE) commissioned the technical support of researchers to develop an outcome-oriented HSPA framework which should reflect the shared priorities of multiple stakeholders, including citizens.

Exploring Changes to the Actionability of COVID-19 Dashboards Over the Course of 2020 in the Canadian Context: Descriptive Assessment and Expert Appraisal Study.

Background: Public web-based COVID-19 dashboards are in use worldwide to communicate pandemic-related information. Actionability of dashboards, as a predictor of their potential use for data-driven decision-making, was assessed in a global study during the early stages of the pandemic. It revealed a widespread lack of features needed to support actionability.

A Web Interface for Antibiotic Prescription Recommendations in Primary Care: User-Centered Design Approach.

Background: Antibiotic misuse is a serious public health problem worldwide. National health authorities release clinical practice guidelines (CPGs) to guide general practitioners (GPs) in their choice of antibiotics. However, despite the large-scale dissemination of CPGs, GPs continue to prescribe antibiotics that are not recommended as first-line treatments.

Features Constituting Actionable COVID-19 Dashboards: Descriptive Assessment and Expert Appraisal of 158 Public Web-Based COVID-19 Dashboards.

Background: Since the outbreak of COVID-19, the development of dashboards as dynamic, visual tools for communicating COVID-19 data has surged worldwide. Dashboards can inform decision-making and support behavior change. To do so, they must be actionable.

Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation.

Objective of this study was to better understand the use of performance data for evidence-based decision-making by managers in hospitals and other healthcare organisations in Europe in 2019. In order to explore why, what and how performance data is collected, reported and used, we conducted a cross-sectional study based on a self-reported online questionnaire and a follow-up interactive workshop. Our study population were participants of a pan-European professional Exchange Programme and their hosts (n = 125), mostly mid-level hospital managers.

QUALITY ASSURANCE OF REGISTRIES FOR HEALTH TECHNOLOGY ASSESSMENT.

Objectives: The aim of this study was to identify guidelines and assessment tools used by health technology agencies for quality assurance of registries and investigate the current use of registry data by HTA organizations worldwide.

Methods: As part of a European Network for Health Technology Assessment Joint Action work package, we undertook a literature search and sent a questionnaire to all partner organizations on the work package and all organizations listed in the International Society for Pharmaco-economics and Outcomes Research directory.

Results: We identified thirteen relevant documents relating to quality assurance of registries.

Addressing the Data Linking Challenges.

Background: PARENT JA (cross-border Patient Registries iNiTiative Joint Action), a joint EU and Member States project, has conducted a research among EU patient registries aimed at gathering information on the registries' interoperability readiness. Leaning on the information and data collected through the previous PARENT JA research, this study aims to provide more detailed view into the registry holders' practical challenges with data linking. Since the studies which dealt with patient data exchange have often neglected the registry holders' performance of data exchange, we wanted to put a spotlight on various EU registry holders' practices and operations, aiming to detect their needs and concerns in the process of running an interoperable registry.

Self-Organizing Maps-based ocean currents forecasting system.

An ocean surface currents forecasting system, based on a Self-Organizing Maps (SOM) neural network algorithm, high-frequency (HF) ocean radar measurements and numerical weather prediction (NWP) products, has been developed for a coastal area of the northern Adriatic and compared with operational ROMS-derived surface currents. The two systems differ significantly in architecture and algorithms, being based on either unsupervised learning techniques or ocean physics. To compare performance of the two methods, their forecasting skills were tested on independent datasets.