Need a training program? Planners have the list

Model center busy formulating five-year plan

By next spring, TB controllers who need a specific training or education program will be able to hop on the Internet and scroll through an exhaustive listing of all the programs that exist on the subject and where to go to get them.

"People have come up with lots of low-budget plans for their own catchment areas, and some of them are astonishingly good," says Elizabeth Stoller, MPH, director of the Francis J. Curry TB Model Center in San Francisco. "This should shine some light on all the resources that exist across the country."

Other organizations have made attempts to create such a master list of educational and training plans, but this marks the first time someone's ever succeeded. "We want to identify gaps and the resources to fill them, so we can provide a blueprint of action for TB education and training," says Stoller.

Compiling the megalist of training resources is only one piece of an even more mammoth undertaking: the model center's project to devise a five-year strategic plan for TB control in the United States.

"We want to provide a way for people to see clearly what others are doing and what resources are available to help them out," says Andrea Green Rush, MLIS, strategic plan coordinator for the center. "It's hard to do your planning in a vacuum."

Both parts of the project, including compiling the resources and formulating a strategic plan, are being spearheaded by the center. Additional input and guidance comes from the remaining TB model centers, and from the Centers for Disease Control and Prevention, says Rush.

The project started in December. Planners began by conducting rounds of interviews, holding focus groups, and surveying TB controllers, nurse educators, and other key organizations. As results began to roll in, Rush and her colleagues began sifting through the mountain of data that resulted.

Six themes began to emerge, Rush says. The themes, in turn, became the focus for six work groups that include the following:

1. Private sector/managed care providers/provider education.

"Managed care was one of the biggest themes that came out of the assessment," says Rush. "In some areas, there's very little managed care; in others, it accounts for over 90% of the care. We need to know how to interact with managed care, and who's doing what."

2. The public sector.

No surprise here: "That's still where most TB care and control happens," Rush says.

3. Correctional facilities.

"It was a surprise to us how much this was an issue," says Rush. "A lot of the discussion centered on how can we get past the finger-pointing and move toward developing systems and interfaces that work?" The first step consists of the two cultures - public health and prisons - getting to know each other better, she adds. "We need to figure out how to better understand each other's organizational and occupational cultures," Rush says.

4. "Special" populations.

This encompasses the homeless, substance abusers, and those who are HIV/TB co-infected. "These groups often overlap," says Rush. "They have a lot in common, but there are also some unique aspects to each one."

5. Foreign-born providers, international medical school grads, foreign-trained providers.

Standards vary between here and there; the task is to get out the word. "There are cultural and linguistic issues, issues around BCG - it's pretty clear-cut here," says Rush.

6. International TB training issues.

International entities have developed their own set of resources; the United States should learn from them, Rush says. "We need to know what training efforts are under way, and what resources are available," she says. By the same token, the United States has resources to share, too.

The strategic plan should be ready for review and comment by next January, says Rush. By next spring, it should be completed. Once finished, the plan will go out to TB controllers, training providers, the CDC, and other federal agencies, says Rush. It will also be directed to potential funders, who can use it to find out where the best places to put their money might be, she adds.