Evaluation of case management in tuberculosis control: a three-year effort to improve case management practices in New York City
Abstract:OBJECTIVE: To describe a 3-year effort to identify factors associated with lapses in case management (CM) and to improve CM practices by New York City Bureau of Tuberculosis Control (BTBC) staff.
DESIGN: Evaluation of the CM of TB cases reported in the second quarter of 2003 and comparison of results with the findings of a similar review conducted in 2002. Implementation of strategies to target areas in need of improvement and identification of interventions that contribute to improved work practices.
RESULTS: From 2002 to 2003, significant improvements were found in some CM indicators, such as patient education about the importance of directly observed therapy (32% vs. 74%), importance of monthly follow-up (24% vs. 51%) and potential for development of drug resistance (36% vs. 61%). Informing patients about the availability of services provided by the BTBC also improved (16% vs. 59%); however, timeliness and documentation of CM activities and implementation of supervisory activities remained poor. Supervisors largely attributed this lack of improvement to poor documentation of work actually performed.
CONCLUSIONS: These evaluations identified lapses in CM practices and program supervision. The findings were used to adjust protocols, target interventions, and focus education and training to improve work practices.
Document Type: Regular Paper
Affiliations: 1: New York City Department of Health and Mental Hygiene, New York, New York, USA 2: New York City Department of Health and Mental Hygiene, New York, New York, USA; and Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: 2007-10-01
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