Milestones and Key performance Indicators to Assess the Capacity of Rapid Response Teams in the Eastern Mediterranean Region: A Methodological Approach

Abstract Background: A country’s capabilities to conduct proper response activities to outbreaks depend on its capacity for early detection and operational efficiency for a timely response through its frontline healthcare workers including public health rapid response teams (RRTs). RRT capacity and operation vary among the countries in the Eastern Mediterranean region (EMR) have never been systematically assessed, therefore, WHO EMRO decided to define a set of indicators that could be used for the evaluation of RRTs' capacity and performance among its member countries. The purpose of the present study was to develop performance measures for assessment of RRT in EMR. Methods: Extensive literature review was carried out for critical elements/themes/categories of RRTs evaluation. Data were extracted using the “descriptive-analytical” method. An initial list of 126 indicators covering 8 themes/categories/ dimensions emerged. Using a modified Delphi paradigm, a multidisciplinary panel group of experts in outbreak response, epidemiology, public health, microbiology, social mobilization, and public health management assisted in the development and selection of the final set of indicators. A final list of 15 performance indicators was developed guided by the theory of change, logic model for RRT, and the RRT cycle. Results: The final list covered 8 categories including workforce of RRTs, presence of standard operating procedures for RRT operations, financial and logistic support of RRTs deployment, timeliness of RRT operations/ activities, documentation and reporting of RRT response, interventional response of RRTs and monitoring and evaluation of RRT activities. Experts agreed upon 15 KPIs in 8 domains related to RRT operations and activities. Conclusion: The developed KPIs are suggested to be used to guide policies and decisions related to RRT performance, operations, and evaluation.