Enhanced TB surveillance system: a user’s perspective
Health Protection Nurse Gary Porter-Jones, from the North Wales Health Protection Team (HPT), writes about his team’s experience of the new web-based enhanced TB surveillance (ETS) database, which should be rolled out nationwide in 2009.
Many of you will be aware that the Health Protection Agency (HPA) has been piloting this new database. Some of you may have been part of the pilot, perhaps as nurses in TB clinics filling out the new blue notification/surveillance forms, or in a health protection unit that uploads the data to the database and uses its comprehensive surveillance functions. Whatever your input, I’m sure you’ll agree that the new system is far better than the local, regional, and national modules of the old ETS.
How it was done
In my region, we provided the TB nurses in the three local clinics with their own usernames and passwords so that they could notify cases of TB and supply the enhanced surveillance data directly onto the online database, creating a truly paperless system. A neighbouring region continued to ask the nurses to complete the revised paper notification forms and post them to the HPT. It was useful to compare approaches and the experiences of the nurses using the different methods.
We found that both groups of nurses were happy with the method they were using. My concern was that the nurses in my region would view uploading the notification data themselves negatively, citing ‘not enough time’, or ‘no access to a computer’. However, I was wrong. They embraced the concept with open arms, viewing it as a positive step and one that underpinned their autonomy and responsibility as competent professionals.
Access is the key
The new ETS is an extremely useful and well-organised database – nurses can access all their patient’s details with a couple of clicks of a mouse button. Once uploaded, the patients details are there for everyone, at every level, who needs them. The local clinic has a well-organised database of their patients; we, at regional level, are alerted each time a new case is notified and we can view possible epidemiological or microbiological links with other cases that are in our region and elsewhere. All this surveillance data is also always available within Wales as well as by the HPA in Colindale, and all within a couple of clicks of the mouse.
In this comprehensive pilot phase, numerous bugs were identified and fixed, and comments were provided on how best to structure it and many of its functions. Hopefully, it is now a tool to help provide an efficient structure to your TB caseload – it certainly is in North Wales.