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Understanding the TB Cohort Review Process: Instruction Guide
2006
Return Table of Contents
What Is the Cohort Review Method?
4. Essential Elements of the Cohort Review Process
TB programs across the country have adopted a variety of
approaches to conducting cohort reviews. All of the approaches
incorporate the same key elements of preparation, presentation, and
follow-up.
Preparation encompasses developing program objectives, ensuring
that sound case management protocols are in place, using a reliable
TB registry, and carefully preparing the case.
The element of presentation includes using a standardized format
for cohort reviews, providing TB case and contact information to
the TB control team, and presenting immediate feedback on goal accomplishment.
Follow-up involves acting on the recommendations of the TB control
team from the cohort review session, ensuring that those patients
and contacts started on treatment complete treatment, and following
up on programmatic issues (e.g., training) that were noted at the
cohort review session. Using this process allows TB programs
to improve outcomes through a continual cycle of learning.
“I see the cohort review as an educational experience.
I learn what it is that staff are doing, it tells me what are the
issues that are there for every patient, what are the barriers that
staff face, and all of the things that they accomplish…”
Sonal Munsiff, MD, Director, Bureau of TB Control,
New York City Department of Health and Mental Hygiene
The following table lists the elements associated with the preparation,
conduct, and follow-up in a cohort review process. It is designed
so that your TB program may conduct an at-a-glance assessment of
its readiness to conduct cohort reviews, and it provides an overview
of what may need to be enhanced in order for you to implement the
cohort review approach.
Exercise 1: TB Program Self Assessment
| Essential Elements
of the Cohort Review Process |
| What are you already doing? |
YES |
NO |
What may need to be enhanced in order for you
to conduct a cohort review: |
| 1. Preparation |
- Ensuring that TB program staff know TB program objectives
|
|
|
- Delineate national, state, and local objectives for your
program
- Communicate these objectives to all TB program staff
|
- Using a comprehensive case management system
|
|
|
- Ensure that case management protocols are clearly written,
comprehensive, and practical for staff to implement
|
- Using a reliable TB registry
|
|
|
- Specify data elements that need to be collected to evaluate
program objectives
- Ensure that staff update registry information regularly
- Use the registry to generate cohort lists for TB control
team members
|
- Carefully preparing cases for presentation
|
|
|
- Use periodic case reviews to ensure that case and contact
information needed for the cohort review is collected
- Consider adding practice sessions to hone case presentation
skills
- Implement a standard form and presentation format to ensure
consistent, concise, and complete presentations
|
| 2. Presentation |
- Presenting each case in detail to the TB control team
|
|
|
- Allow team members sufficient time to analyze and evaluate
TB cases and contact investigations
|
- Providing on-the-spot feedback to staff, troubleshooting,
and aggregate reporting
|
|
|
- Allow time for troubleshooting of case management issues
- Develop a standard format for aggregate reporting of data
|
| 3. Follow-up |
- Following up on noted problems
|
|
|
- Team members use information gathered at cohort review
to follow up on cases and contact investigations, address
staff training issues, and solve programmatic problems
|
These elements of cohort review will be detailed in the next chapters.
Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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