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Understanding the TB Cohort Review Process: Instruction Guide (2006)

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What Is the Cohort Review Method?

1. Program Objectives

Increased accountability helps TB control programs meet their program objectives and national objectives. In order to assess progress in attaining objectives, TB control teams must clearly delineate the desired outcomes. Programs often have layers of objectives that they are striving to meet simultaneously. At the national level, the Centers for Disease Control and Prevention provides objectives for all programs they support. State or local TB control programs may also set objectives for program performance. The following are examples of layered program objectives that can be monitored with the use of cohort review.

Table 2: Examples of TB Program Objectives

Actual
CDC National Objectives*
  • At least 90% of confirmed TB cases will complete treatment within 365 days.
  • At least 90% of sputum AFB-smear positive TB cases will have contacts identified.
  • At least 95% of contacts to sputum AFB-smear positive TB cases will be evaluated.
  • At least 85% of infected contacts started on treatment for LTBI will complete treatment within 365 days.
Examples
of State Objectives
  • At least 80% of TB cases will be treated by DOT.
  • For close contacts placed on treatment for LTBI, at least 90% of those persons under 15 and 75% of persons 15 and older will complete a recommended course of LTBI treatment.
Examples
of Local Objectives
  • Health department staff will interview at least 90% of persons with TB disease within 3 business days of case notification.
  • At least 90% of contact investigations will be completed within 90 days.

* “Department of Health and Human Services, CDC, Tuberculosis Elimination and Laboratory Cooperative Agreements, Program Announcement Number 05003” (also referred to as the “FY 2005 TB Cooperative Agreement”).

“The benefit of cohort review, in my experience, is that you really are changing the knowledge base of those who are practicing TB prevention and control…in just a year, we had improved timeliness of contact investigation and improved quality of our contact investigation.”

Kim Field, RN, MSN, TB Program Manager, Washington State Department of Health TB Program


 
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