This is due to a rise in the complexity of cases, the implemented changes from NICE Guidelines and from the TB Strategy/New Entrant Screening Programme for latent TB.
I recently conducted an audit for latent TB case management. It was always known that not all patients fit within the standard pathway. For example, many latent cases require enhanced case management (ECM) due to patients suffering from adverse reactions to medications. Where additional case management was provided it was not recorded. This is because either current databases need to be updated or a separate system needs to be adapted.
The same applies to active cases. Great efforts are being put into to getting a patient to complete a regime of treatment. This may vary from monitoring hepatotoxicity to direct observed therapy. What goes unseen are all the attempts made of getting contact tracing complete, family support, etc.
To ensure all our work doesn’t get overseen, we must record data where ECM has been provided. It is only by audits and data collection we can measure against standard case management and different levels of ECM. Such data can not only support the difference we are making, but it is also essential to a successful business case for recruitment.
