[MCOH-EH] [EXTERNAL] Re: TB testing (TST): tuberculin skin testing
Sally Foster-Chang
sarah.a.fosterchang at gmail.com
Mon Mar 18 05:04:34 PDT 2024
Not to mention better compliance. When you factor in the additional time
associated with follow up when individuals do not return to have PPDs read,
it represents a significant amount of unproductive staff time. We saved
1,300 hours per year transitioning to IGRAs! And those resources could then
be dedicated to other projects.
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On Mon, Mar 18, 2024 at 7:52 AM Carr, Jennifer L. <
Jennifer.Carr at vandaliahealth.org> wrote:
> Darryl,
>
> When we transitioned to IGRA, In addition to the cost of the TST, I
> included the cost of the nurse’s time to place and read as well as the time
> for the employee to be away from the workplace to complete the TST
> placement and read. I estimated 10 minutes for each visit for the nurse and
> employee. This helped to offset the cost and the rest was justified by
> higher accuracy, industry standard comparison and increased efficiency of
> the workflow.
>
> Hope this helps you to support the transition.
>
> Jennifer
>
>
>
> *From:* MCOH-EH <mcoh-eh-bounces+jennifer.carr=
> vandaliahealth.org at mylist.net> *On Behalf Of *Lesoski, Darryl via MCOH-EH
> *Sent:* Friday, March 15, 2024 9:59 AM
> *To:* MCOH-EH <mcoh-eh at mylist.net>
> *Cc:* Lesoski, Darryl <DLESOSKI at mhc.net>
> *Subject:* Re: [MCOH-EH] [EXTERNAL] Re: TB testing (TST): tuberculin skin
> testing
>
>
>
> Yes, I know all this and have this as an option but it is 4x the cost of a
> TST. SO I wanted to help our employers / businesses out by being cost
> minded and the ONLY reason I asked this question was finding out about how
> you all handle interpretation if you aren’t around to read it.
>
>
>
> THANKS for the input
>
>
>
> *From:* MCOH-EH <mcoh-eh-bounces+dlesoski=mhc.net at mylist.net> *On Behalf
> Of *Wendy Thanassi
> *Sent:* Thursday, March 14, 2024 4:19 PM
> *To:* MCOH-EH <mcoh-eh at mylist.net>
> *Subject:* [EXTERNAL] Re: [MCOH-EH] TB testing (TST): tuberculin skin
> testing
>
>
>
> You don't often get email from wendy.thanassi at gmail.com. Learn why this
> is important <https://aka.ms/LearnAboutSenderIdentification>
>
> Hello Darryl and all,I am potentially no help at all... but all of the
> logistic and medical (lack of follow-up, documentations and recording
> challenges, quality challenges) are alleviated by using an IGRA blood test.
> May I ask why you don't do that and if there is anything I
>
>
>
>
> *Hello Darryl and all,*
>
>
>
> *I am potentially no help at all... but all of the logistic and medical
> (lack of follow-up, documentations and recording challenges, quality
> challenges) are alleviated by using an IGRA blood test. May I ask why you
> don't do that and if there is anything I can do to discuss the possibility
> with you or your clinic?*
>
>
>
> *We eliminated TST testing all together on January 1, 2009 and have never
> done one since then.** PLEASE feel free to contact me if there's room for
> discussion on use, location, cost, efficiency etcetera!*
>
>
>
> *To answer these below:*
>
> *1. No*
>
> *a. No*
>
> *b. The standard is to use IGRAs: since 2017 when the joint CDC/ ATS/ IDSA
> /ACOEM guidances were written that say** "IGRA is preferred over TST IN
> ALL SETTINGS"** for many reasons, including the ones you raise above. But
> first and foremost because it is much more reliable, and MMR/VZV titres are
> usually being drawn anyway.*
>
>
>
> *I suppose it'd be fine to do in separate places if you're still using
> TST, you'd just need good documentation. *
>
> *Or.... do a QFT/TSPOT and then the whole problem goes away?! :)*
>
>
>
> *2. Because of incubation availability, draw IGRA's until 2pm Friday and
> then we give the lab a few hours to process it.*
>
>
>
> *I don't mean to be a pain, I mean to be helpful. Let me know if there's
> more I can do to help you get out from under TSTs.*
>
>
>
> *Best always,*
>
> *Wendy*
>
>
>
> *Wendy Thanassi MD, MA, MRO*
>
> *VA Palo Alto HCS*
>
>
>
> On Thu, Mar 14, 2024 at 10:09 AM Lesoski, Darryl via MCOH-EH <
> mcoh-eh at mylist.net> wrote:
>
> Couple of questions: THANKS for any input, feedback, suggestions!
>
>
>
> 1. Does any provider or clinic place TSTs for patients and let them go
> elsewhere for the read/interpretation?
>
>
> 1. What is our liability if we administer the TST, but allow
> interpretation elsewhere?
> 2. What is the current practice standard for administration and
> interpretation of a TST? They should always be done in the same
> clinic/practice? Or can they be completed at 2 separate and non-related
> clinics/practices?
>
>
> 1. Does any provider or clinic *NOT* place TSTs on THURSDAYs because
> you are not available on the Saturday or Sunday to provider the
> interpretation?
>
>
>
> We have created some scenarios with the guidance/recommendations at our
> medical center that hampers our clinical operations to outside
> clients/businesses and want to know what the rest of you are all doing 😊
>
>
>
> Personally, I have no qualms letting my staff administer the TST and
> allowing the individual to go elsewhere for interpretation (but then again,
> I may be a little more “liberal” in my practice processes than others).
>
>
>
> THANKS for the reply and appreciate your input. Darryl
>
>
>
>
>
> *Darryl Lesoski, MD, MPH, FACOEM*
>
>
>
> *System Medical Director – Occupational Health and Medicine, Employee
> Health*
>
> *Munson Medical Center*
>
> *Munson Occupational Health and Medicine*
>
> *Email: dlesoski at mhc.net <dlesoski at mhc.net>*
>
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