[MCOH-EH] [EXTERNAL] Re: TB screening for high risk facility

[Lanzi, Maria]

Dr. Adamo,

Would you be willing to share your algorithm?

Thanks,

Maria


Maria C. Lanzi, MS, MPH, ANP-BC, COHN-S, CTH
Nurse Practitioner/Program Coordinator
Employee Occupational Health
Corporal Michael J Crescenz Veterans Affairs Medical Center
3900Woodland Avenue
Philadelphia, PA 19104
Work:  215 823 5800 x 2592
Fax:  215 823 5968



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Philip Adamo
Sent: Friday, September 16, 2016 2:56 PM
To: MCOH/EH
Subject: [EXTERNAL] Re: [MCOH-EH] TB screening for high risk facility

Hello Elena
We switched to IGRA testing last year. We use tspot and we think it the best decision. I have created an algorithm when the test is not negative. It eliminates the the return of the employee 4 times.
It eliminates the false positives of a skin test on employees who have received BCG.
From a financial point you will get push back. The response should be the indirect cost of having an employee leave the unit 2 times at a minimum. This takes about 20-30 minutes each time. If they forget to return, double that.
We are instituting a travelling phlebotomist who will go to the different units/buildings each month.
We are a medium risk facility with over 12,500 employees.

Philip Adamo, MD, MPH, FACOEM
Medical Director
Baystate Health
Springfield MA

Sent from my iPhone
Sorry for typos

On Sep 15, 2016, at 3:05 PM, Elena Riker <riker at ohsu.edu<mailto:riker at ohsu.edu>> wrote:
We are a “high risk” facility for TB so we do a 2 step TST on hire then one annually.  We have about 8000-10000 people who need this per year.  Can anyone in a high risk facility tell me how you manage this?  Does anyone do all IGRAs?  Does anyone do IGRA on hire, then TST annually?  We are looking at ways to do our onboarding differently to ensure staff are compliant before starting work.  Seems like asking employees to come 4 times for a 2 step TST preplacement is a lot to ask.  We are considering making everything due prior to starting, but just one TST required to start, then hope we capture their 2nd TST after they start – seems like this may cause problems….thoughts/ideas appreciated!  Elena


Elena Riker, CMA
Clinic Operations Supervisor
Occupational Health - OHSU
riker at ohsu.edu<mailto:riker at ohsu.edu>
p: 503 346-0186 | f: 503-494-4457
My office hours are: M-F 7:00 AM – 3:30 PM

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