An Evaluation of the Idaho Tuberculosis Case Management Teleconferences (2005)
Christine Hahn, Kathy Cohen, Fernando del Rosario, Lisa Pascopella, Karen R Steingart
Background: Case management is an essential component of tuberculosis (TB) control in the United States. A needs assessment in Idaho, Montana, Utah, and Wyoming conducted in 2003 as part of Task Order 6* found limited systems to ensure the quality of case management. To address this need, teleconferences were held in monthly, one-hour call-in sessions with the state TB program and local health districts. During the session, a local public health nurse presented a case using a standard format followed by interactive discussion facilitated by the state TB Controller; national nurse and physician experts participated. An evaluation of the teleconferences was conducted.
Objectives: To determine if the teleconferences were worthwhile; to improve the teleconferences; and to provide recommendations to other low-incidence areas.
Methods: Idaho TB program and TO6 staff collaboratively developed a questionnaire that was posted online. Conference participants were invited to complete it. Responses were compiled and analyzed with Zoomerang.
Results:Response rate was 90% (17/19): ten nurses, three physicians, and four epidemiologists. Eighty-two percent of the respondents had worked in public health for at least five years, though 76% of the respondents currently spent less than one-fourth of their time in TB. About half (47%) of the respondents were directly responsible for case management. Eighty-eight percent of the respondents felt outside TB experts enhanced the teleconferences (undecided, 12%). A majority of the respondents answered, that after participating in the teleconferences, they felt confident about the following case management activities: performing initial patient assessment (88%); conducting contact investigations (88%); and identifying barriers to adherence (94%). However, a lower proportion was confident about using legal actions to ensure adherence in a difficult patient (65%). Ninety-four percent of the respondents expressed interest in future teleconferences (undecided, 6%).
Conclusions: Idaho TB staff valued the teleconferences as a way of improving case management skills. This evaluation highlighted specific case management activities for education and provided an opportunity to share lessons learned. The teleconferences and their evaluation have been discussed at the Idaho epidemiology training (May, 2006), National Tuberculosis Controllers Association (June 2006), TO 6 annual meeting (August 2006), and CDC Division of TB Elimination webinar (September 2006).
Note: The Idaho teleconferences, with continued involvement of TB experts, have resumed.
* Task Order #6 "Regional Capacity-Building in Low-Incidence Areas," Tuberculosis Epidemiological Studies Consortium, CDC
For information, please contact:
Karen R. Steingart, MD, MPH
 Click to view/download Report and Worksheets
(Word, 571 kb)
 Click to view/download Poster
presented during the National Tuberculosis Controllers Association Conference, June 2006
(PDF, 39 kb)
Click to view/download Presentation Slides presented during a CDC Webinar, September 2006
(PDF, 262 kb)
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