Rajita Bhavaraju
Deputy Director
NJMS-Medicine-Global Tuberculosis Institute
rajita.bhavaraju@rutgers.edu
Project Sponsor:
Alfred Lardizabal, MD
Associate Professor of Medicine and Executive Director
NJMS-Medicine-Global Tuberculosis Institute
Abstract:
The Lattimore Practice at the Rutgers Global Tuberculosis Institute serves patients with active tuberculosis, contacts, B-waiver immigrants, and some high-risk patients with latent tuberculosis infection (LTBI) from University Hospital’s (UH) ambulatory care clinics. LTBI patients, who are not always high priority, often call the clinic anxious for an appointment after being referred by their provider. Often, a nurse needs to be called in to speak to and re-assure the patient about not needing an appointment right away. The call back to the patient does not happen immediately. Additionally, the process would be easier, if the referring providers made the appointment instead, and then educated the patient. There is a need for up-front patient education prior to the clinician encounter and for LTBI patients prior to coming to the clinic.
Methods: The project’s goals are to 1) integrate new educational responsibilities into the job roles of the registration staff, via a systematic process of change management, and content and skills-based training; 2) create a systems change in the referral process of LTBI patients by way of a simple, shared algorithm for the referral, appointment, and pre-appointment process.
Limitations: There are several possible challenges or obstacles. First, Human Resources may feel that the role change is not within the responsibilities of the involved staff. Next, all registration staff may not be willing to take on a new role. This could be due to discomfort with change, or the feeling that this is not part of their job. Finally, patients or referring providers may “push back” on a lay staff person providing education or not prioritizing the specific patient’s care.
Conclusion. The successful implementation of this project will empower of lay-clinic staff, increase patient satisfaction, grow efficiency for the patient schedulers, and remove time burdens from clinical staff.