Ensuring accountability: the contribution of the cohort review method to tuberculosis control in New York City.
METHODS
In 1993, the New York City (NYC) Bureau of Tuberculosis Control developed the cohort review process as a quality assurance method to track and improve patient outcomes.


METHODS
The Bureau Director reviews every tuberculosis (TB) case quarterly in a multi-disciplinary staff meeting. In 2004 we also began collecting details on issues identified at cohort review to quantify how this process directly impacts TB control efforts.


RESULTS
From 1992 to 2004, NYC TB cases decreased by 72.7% and treatment success rates significantly increased by 26.7%. Implementing the cohort review was key to improving case management, thus leading to these results. For the 1039 patients in 2004, 596 issues were identified among 424 patients; 55.0% were incorrect, unclear or unknown patient information, 13.8% were treatment issues, 12.4% were case management issues and 10.6% were incomplete contact investigations. Most (76.5%) issues were addressed within 30 days of the cohort reviews.


CONCLUSIONS
A systematic review of every TB case improves the quality of patient information, enhances patient treatment and ensures accountability at all levels of the TB control program.
Munsiff
S S
SS
New York City Department of Health and Mental Hygiene, New York, New York, 10007, USA.
Ahuja
S D
SD
King
L
L
Udeagu
C C
CC
Dorsinville
M
M
Frieden
T R
TR
Fujiwara
P I
PI
D019090:Case Management; D016358:Contact Tracing / Q000706:statistics & numerical data; D018563:Disease Notification / Q000706:statistics & numerical data*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D009937:Organizational Objectives; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation / Q000379:methods; D011635:Public Health Administration / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000458:organization & administration; D012941:Social Responsibility; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission