[MCOH-EH] Timing of annual TSTs in inpatient units: By date of birth, alphabetically, date of hire?

[Swift, Melanie D., M.D.]

Hi Ed,
You'll need to look at your internal compliance tracking system and your method of TST or IGRA service delivery to determine what works for you. (But I definitely do not recommend you go alphabetically. Many women choose to change their surname when they change their marital status, and nursing is a profession predominated by women.)

Just bear in mind that whatever you initially set up, people will inevitably get off track. Decide how you want to handle these scenarios:

*         If doing TSTs, there will be people who fail to return for reading. They will have to have another TST placed, which can put them off schedule, sometimes by weeks to a month depending on how finely tuned your compliance tracking system is, and how rigorously it's enforced.

*         Many hospital staff work at more than one facility (e.g. PRN staff) and may submit testing from the other facility one year, needing a test a year later in your facility. You can always insist on doing your own testing instead of accepting external documentation, but it does save resources and improves employee satisfaction if you accept documentation and adjust their next due date.

*         People go out on extended leave for maternity, FMLA, etc and miss their annual test, and should get it whenever they return. (Inpatient nursing is also full of women in childbearing years.)

*         TB exposures happen, and will result in additional testing off-cycle. Again it's your policy decision about whether you just pick up annually from the date of their exposure followup test, or insist on keeping their annual testing marching forward. That approach could simplify things depending on your system, or not, but is unlikely to make sense medically or be acceptable to the employee.

If you have the technologic ability to set their annual test due based on their last completed test, that would be ideal. It does require that they have access to testing year-round.

Best wishes,
Melanie

Melanie Swift, MD
Senior Associate Consultant
Division of Preventive, Occupational, and Aerospace Medicine
Phone 507.284.2560
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org<http://www.mayoclinic.org/>

From: MCOH-EH [mailto:mcoh-eh-bounces+swift.melanie=mayo.edu at mylist.net] On Behalf Of Galaid Edward I
Sent: Wednesday, November 08, 2017 12:59 PM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Timing of annual TSTs in inpatient units: By date of birth, alphabetically, date of hire?

We are reconfiguring our tuberculosis surveillance, driven by a change in staffing and location of the employee health office in each hospital.  Will be doing them either on the inpatient units, or in the employee health office.  The question is, scheduling the test:  by date of birth, by alpha, or date of hire.  What do you do, and why?
Thanks

Ed Galaid

Edward I. Galaid, MD, MPH
ABIM, ABPM (OM)
Medical Director, Roper St. Francis Physician Partners Occupational Medicine
Charleston, SC
Member, ACOEM Task Group,  Guidance for the Medical Evaluation of Law Enforcement Officers
(O) 843-402-5053


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