Table 2: Master list of quality assurance tools for TB surveillance, United States, 2011.
(a) Quality assurance protocol tools

Tool numberTool nameDescription and how to useFormat

QA protocol-1Cooperative agreementThe original version of the TB surveillance section of the cooperative agreement.PDF

QA protocol-2QA written protocol-requirementsA table that lists all of the cooperative agreement requirements for TB surveillance and sources for information.Word

QA protocol-3QA written protocol-guideA guide to help jurisdictions write their own protocol.Word

(b) Case detection tools

Tool numberTool nameDescription and how to useFormat

Case detection-1TB program area module (TB PAM) flow chartFlow chart to help with patient search. This flow chart was created initially to emphasize the importance of always searching for a patient within TB PAM so that duplicate patient records are not created. This flow chart also outlines the process for creating “Provider Verified” cases and addresses approval and rejection of notification.Word

Case detection-2Notification processFlow chart that shows a tiered notification process for TB case notification. This flow chart identifies (1) what role each person (with a particular TB PAM right) has in the notification process and what happens when a notification is rejected or approved. Only TB program managers (a nurse within the TB program) creates a notification, and it must be approved by the TB Program Central Office Epidemiologist before it is sent to CDC for case counting.Word

Case detection-3TB suspects weekly reportThis report is generated weekly for all suspects reported in TB PAM through Friday of the previous week. Suspects are classified as a case or not a case within 56 days from the date of report. There is a built-in calculation that calculates 56 days from the date of report (when the date of report is entered). All suspects that are past due (over 56 days) require a followup from one of the Central Office Nurse Consultants.Excel

Case detection-4Case verification and treatment statusTable that indicates case verification and treatment status. This spreadsheet is used to monitor treatment progress with the goal of completing treatment within 12 months. There are built-in calculations for 3, 6, 9, and 12 months from treatment start that are populated when the date therapy started is entered. Case verification is included to help identify how long treatment is anticipated for.Excel

Case detection-5Decline in reported tuberculosis cases surveySample survey to investigate decline in reported TB cases.Word

Case detection-6Counted tuberculosis case verification reportForm that indicates counted TB case verification.PDF

Case detection-7Investigation process for underreporting of TBTable that provides a process for investigating underreporting of TB data.Word

Case detection-8aTB case closeout letterSample letter to accompany TB case close list (tool 8b) and TB case closeout form (tool 8c).Word

Case detection-8bTB case close listList by jurisdiction indicating TB case closeout status.Excel

Case detection-8cTB case closeout formForm for confirmation/signature of number of TB cases.Word

(c) Accuracy tools

Tool numberTool nameDescription and how to useFormat

Accuracy-1aData accuracy checklistA checklist for reviewing RVCT data for accuracyWord

Accuracy-1bData accuracy checklist CDC SAS codeSAS code corresponding to the data accuracy checklist, accuracy tool-1a, and is based on CDC RVCT variable names.Word

Accuracy-1cCDC TB surveillance RVCT data dictionaryData dictionary for interpreting the CDC RVCT variable names used in data accuracy checklist CDC SAS code, accuracy tool-1bExcel

Accuracy-2Options for prioritizing medical chart reviews when resources are limitedVarious options to help prioritize medical chart reviews when resources are limited.Word

Accuracy-3RVCT surveillance database audit formChecklist for checking the accuracy of RVCT.Word

Accuracy-4Accuracy checklist for sputum culture conversionTable to indicate number of days for culture conversion by jurisdiction. This applies to cases that are sputum culture positive only. There are built-in calculations that calculate the date, that is, 30 and 60 days from treatment start (once the date therapy started is entered). There is also a built-in calculation for the number of days that it took for sputum culture conversion. This helps identify those patients who did not meet the National Tuberculosis Indicators Project (NTIP) Objective of converting their sputum culture within 60 days of treatment initiation.Excel

Accuracy-5Nucleic acid amplification test (NAAT) comparisonsComparison of NAAT tests.Excel

Accuracy-6RVCT calculated variablesRVCT calculated variables algorithm for calculating vercrit.Word

Accuracy-72009 RVCT form with public health information network (PHIN) variable identification2009 RVCT form with PHIN variable identification by RVCT question number to use as a reference for report codes.PDF

(d) Completeness tools

Tool numberTool nameDescription and how to useFormat

Completeness-1Source list for locating RVCT dataSource document to locate information for each item on the RVCT.Word

Completeness-2Therapy statusTable to indicate therapy status by 12-month interval. This spreadsheet is used to monitor treatment progress with the goal of completing treatment within 12 months. There are built-in calculations for 3, 6, 9, and 12 months from treatment start that are populated when the date therapy started is entered. This tool targets the NTIP objective of treatment completion within 12 months.Excel

Completeness-3Culture and drug susceptibility statusTable to indicate culture and drug susceptibility status by jurisdiction. This report shows the susceptibility results for isoniazid, rifampin, pyrazinamide, and ethambutol. This shows those cases that are multidrug-resistant TB and also those who have an unknown or blank susceptibility report. This is for all culture-positive TB cases. This tool targets the NTIP objective of drug susceptibility reporting.Excel

Completeness-4TB Program area module (TB PAM)Flow chart that shows the TB PAM process (initiation of RVCT through case closure). This flow chart was created for the TB PAM from initiating the RVCT to closing a case. This flow chart also identifies the responsible person(s) for the various steps.Word

Completeness-5Data abstraction instructionsDetailed procedures for RVCT quality control queries.Word

Completeness-6aRVCT variables used in NTIPList of the RVCT variables used in the NTIP indicator calculation.PDF

Completeness-6bRVCT variables used in NTIP spreadsheetSpreadsheet of the list of the RVCT variables used in the NTIP indicator calculation.Excel

(e) Timeliness tools

Tool numberTool nameDescription and how to useFormat

Timeliness-1aBuilding blocks—schedule for entering RVCT dataTimeline table. This is a building-block diagram addressing what RVCT variables should be entered and identifies the time frame when those variables should be entered. This helps field staff know when information should be available and when the state central office expects it to be entered.Word

Timeliness-1bSchedule for entering RVCT dataTimeline table similar to timeliness tool 1a. It is in a table format rather than the graphic of the building blocks.Word

Timeliness-2Quarterly case summaryDocument that summarizes timeliness measures and objectives for a predetermined set of TB patients. Predefined case outcome objectives are presented for that particular set of TB patients.Excel

Timeliness-3Timeliness data dictionaryDescription of the data used to calculate timeliness measures for analysis. These measures are used to determine completion of state objectives.Word

Timeliness-42010 Final verbal case counts and data submissionsSpreadsheet for case count.Excel

Timeliness-5Timeline for reporting TB data to CDCTimeline for reporting TB cases and final TB data transmissions to CDC.PDF

Timeliness-6Typical weekly data availability chartTypical weekly data availability by day of the week.PDF

(f) Data security and confidentiality tools

Tool numberTool nameDescription and how to useFormat

Data security and confidentiality-1Standards for data security and confidentialityList of minimum standards to facilitate data sharing and use of surveillance data for public health action.Word

Data security and confidentiality-2Initial assessment of TB program data security and confidentialityGuide for the initial assessment of TB program’s data security and confidentiality.Word

Data security and confidentiality-3Checklist for ongoing assessment of programsComprehensive checklist for assessing data security and confidentiality.Word

Data security and confidentiality-4Data security and QA checklistA TB program’s checklist for data security and QA.Word

(g) Other tools

Tool numberTool nameDescription and How to UseFormat

Other-1QA protocol exampleFour-phase process for entering RVCT data, to conduct quality control, and ensure timeliness in reporting.Word

Other-2QA in surveillance literature sourcesReferences for quality assurance of surveillance data.Word

Other-32009 trending guidanceMapping the old RVCT data to the new RVCT data and diagrams to illustrate the following three RVCT items:
(i) 16—site of disease,
(ii) 22A—X-ray,
(iii) 46—type of health care provider.
This document provides a visual explanation of the transition between old and revised RVCT variables. Mapping shows the user exactly how the definitions of previous variables match up with the new ones.

Other-4Cohort review preparationTimeline for planning and conducting a cohort review session. Includes preparation timeline and job responsibilities. Determines when participants need to be notified of scheduled events leading up to the cohort review session.Word

Other-5TB case/suspect QA review formA checklist to use when reviewing TB cases/suspects.Word

Other-6TB review and QA scheduleQuality assurance schedule for various reviews of TB cases/suspects.Word