Resources for FQHCs on TB: Toolkits and More Nisha Ahamed, MPH Rutgers, The State University of New Jersey
Objectives & Outline At the end of the session, participants will be able to: 1. Identify risk of TB infection or disease in vulnerable populations 2. Describe treatment considerations for TB in vulnerable populations 3. Identify appropriate tools and resources on TB for use in primary care settings
Outline RTMCCs and what they can offer Available resources Demo of Toolkits Final thoughts
CDC TB Regional Training and Medical Consultation Centers Curry International Tuberculosis Center: www.currytbcenter.ucsf.edu Global Tuberculosis Institute: http://globaltb.njms.rutgers.edu/index.html Heartland National Tuberculosis Center: www.heartlandntbc.org Mayo Clinic Center for Tuberculosis: http://centerfortuberculosis.mayo.edu Southeastern National Tuberculosis Center: http://sntc.medicine.ufl.edu
RTMCC Activities TB RTMCCs are regionally assigned to cover all 50 states and the U.S. territories to: Provide training and technical assistance to increase human resource development in TB programs Develop and distribute TB educational materials Provide medical consultation to TB programs and medical providers
RTMCC Trainings TB Clinical Intensive Workshops/Courses TB Clinical Updates Provision of tailored offsite training Webinars Variety of clinical and public health topics Long term and short term utility All webinars are archived Can be accessed live or viewed on-demand (Different ways to do so, you tube, podcasts etc.) Easy to access and contain relevant information packaged into a short time frame
RTMCC Educational Resources
RTMCC Toolkits Requested by CDC to bring together tools and resources in specific areas where there is a national need Toolkits include resources and tools from CDC, RTMCCs, TB Programs and other sources Each RTMCC assigned a topic Federally Qualified Health Centers - GTBI Homeless Shelters Curry Center Neonatal ICU - HNTC Emergency Departments - Mayo Clinic Corrections - SNTC
GTBI Toolkit for FQHCs/CHCs FQHC clinicians have a unique opportunity to identify those at risk for latent TB infection (LTBI) and TB disease Clinicians can have significant impacts, both for individual patients and from a public health perspective by: Understanding who is at risk for TB Screening appropriately Diagnosing and treating TB infection Maintaining a high index of suspicion for TB disease in high risk populations But.busy clinicians with many areas of focus and very little time
GTBI Toolkit for FQHCs/CHC Toolkit designed to provide key information in one place in concise, brief, easy to use format: Brief videos, webinars, pocket cards and more Contains information for FQHCs and TB Programs Information can be used by an individual or for training & educating others Developed based on previous needs assessments Solicited review and input from PCAs, FQHCs TB Programs and others Living document, new tools can be added! http://globaltb.njms.rutgers.edu/educationalmaterials/tookitfqhc.html
FQHC Toolkit: Key Materials TB Program contacts TB 101 online course LTBI Multimedia Videos (GTBI) Latent Tuberculosis Infection: A Guide for Primary Care Providers (CDC) CDC Guidelines CDC Factsheets LTBI in Special Situations (SNTC) Webinars Diagnosis and Treatment of LTBI Pocket Card (GTBI)
Next Steps Continued input from TB Programs and PCAs Contributions from you!!! Tools and suggestions will be reviewed New tools developed as needed
TB among Persons Experiencing Homelessness Photo by Liz Frye, MD, MPH
Curry International TB Center s- TB among the Homeless Toolkit Curry has a tradition of providing tools to address TB control among the homeless Curry publication and tool: Shelters and TB: What staff need to know What about other homeless providers?
Curry International TB Center s- TB among the Homeless Toolkit Collaborative process with input from stakeholders CDC United States Interagency Council on Homelessness National Healthcare for the Homeless Council
Bridging the Knowledge Gap Homeless Service Agencies Dynamic world USICH eliminating homelessness among veterans Housing first Shift away from funding large shelters and transitional housing Have many other competing priorities TB has become a legacy issue or a box to check on an application
Bridging the Knowledge Gap TB Programs Combining with others into Communicable Disease Departments Community presence is changing Diminishing resources means that cases and close contacts are the focus of care and treatment Competing priorities, hard to focus on difficult populations that require significant resources
Toolkit Provide the resources and tools for TB programs to access the experts in homeless services Link to housing Substance use evaluation and treatment Mental health resources Health care for the Homeless for primary care and other health needs Care management that extends upon TB control Provide the resources and tools for homeless service providers to access TB experts What is the risk in my facility? Who are my health department contacts? How do I educate my staff, volunteers, and clients? How do we establish an MOU? How do we address 1 case of TB More than 1 case An outbreak?
http://www.currytbcenter.ucsf.edu/sites/default/ files/product_tools/homelessnessandtbtoolkit/
Other RTMCC toolkits.
Corrections toolkit http://sntc.medicine.ufl.edu/correctionstoolkit.aspx
Corrections tools Place Icons here Contact SNTC: 888-265-SNTC
NICU Tool Kit: Identification and Management of the Neonate After Suspected TB Exposure Overview: The toolkit will contain information on identifying and managing a suspected TB exposure in a neonatal unit and to assist in identifying infection control procedures and contact investigation surrounding a NICU exposure. Target Audience: Nurses, Physicians, Health Care Workers and TB Program Staff Contents: Articles, Guidelines, Fact Sheets, Videos and Guides related to TB and pediatric TB materials, infection control, communication resources, LTBI treatment, diagnosing TB in children, treatment recommendations for children, etc. Status: Under development. Expected to be pilot tested by June 2016. Opportunities for input and feedback: Partners will have an opportunity for input and feedback. Please contact Heartland staff at 1-800-839-5864.
ED Toolkit 2014 MFMER slide-24
ED Toolkit Quick guides/decision trees for ED staff 2014 MFMER slide-25
Toolkit Resources Who to Consult Where to Report Infection Control Case Presentations Applicable Resources Estimated Completion December 2015 2014 MFMER slide-26
A few more resources
RTMCC All Product Page Central Listing Search by Words Search by RTMCC http://sntc.medicine.ufl.edu/rtmccproducts.aspx
Additional resources CDC resources Multiple educational materials: http://www.cdc.gov/tb/education/default.htm Find TB Resources http://www.findtbresources.org TB Education and Training Meeting (TB-ETN) TBEducate Discussion http://discussions.cdcnpin.org/connect.ti/tb_educate/grouphome National Tuberculosis Controllers Association Your RTMCC and what they can offer Medical consultation resources Training and education resources Training courses Minifellowships
Final Thoughts Shift in focus on LTBI as part of TB elimination creates a unique opportunity for partnership between TB Programs and primary care providers FQHCs and CHCs can make a significant contribution to TB prevention, care and control There are many resources and tool available that can assist We want to hear what other tools you need!
Questions and Comments???