The Employee Fast Track Study:

We designed a study to examine factors associated with treatment initiation and completion among health care workers at Harlem Hospital. The study identified barriers including prolonged waiting times, lengthy assessments by multiple providers, lack of reminder/recall systems, and inconsistent provider decisions about indications for LTBI treatment. A multi-disciplinary group consisting of the clinic manager, providers, and health educators developed a program which includes a streamlined visit process and evaluation criteria, specialized forms for patients and providers, an interactive database for patient information, color-coded charts, and a computerized reminder/recall system. Significant results were achieved: Initiation rates increased from 62% to 87%, and completion rates increased from 12% to 85%. Gender, race, foreign birth and BCG status were not significantly associated with initiation or completion of LTBI treatment. Physicians and nurses were found to be less likely than other hospital employees to initiate treatment for LTBI. Older health care workers were more likely to complete treatment for LTBI.