Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53–10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25–6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46–8:52).