This application seeks to improve the teaching of TB to health care workers, standardize care, and disseminate information to the public in a community with high incidence of TB. The current Albert Einstein College of Medicine TB curriculum will be expanded in all years. The epidemic of TB will be introduced in the first year, and case discussions will be added in the second, third, and fourth years. A schedule of regular seminars will be developed to enhance the education of the diverse group of health care workers who provide care for TB patients. In the inpatient setting, nurses, house officers, attending physicians, and respiratory therapists will be targets for intensive education efforts. For outpatient practitioners, education will include general disease issues and site-specific concerns. In collaboration with other departments, standard of care guidelines will be developed and disseminated. Mandatory infectious diseases consultation on all inpatients with TB, automatic evaluation by the institution's Directly Observed Therapy (DOT) program, and development of a group of local TB experts available for consultation are intended to enhance clinician education and the quality of care. A multidisciplinary group, including Department of Health personnel, will be organized to discuss TB issues in the community and stimulate clinical research. Community organizations serving patients with TB or at risk for TB will be included in educational efforts through seminars and literature. Baseline data from questionnaires, focus groups, and chart audits will be compared to post-intervention data to obtain a qualitative and quantitative evaluation of the education program.
