TB and ED discharges and disposition

Good morning

Patients may be referred to the TSTU (Tuberculosis Surveillance and Treatment Unit) following an ED visit for the next available non-holiday weekday.

Procedure

1.  Ask the patient to go to J1-05 Immunology Clinic from 8 AM to 3:30 PM. (the earlier the better).  After they enter the Immunology Clinic, the first door to their immediate left is the TSTU (door is marked IPaC TSTU Clinic).
2.  Provide the patient with a mask and ask him/her to wear it to the TSTU.
3.  The patient should state that he/she was seen in the ED and was asked to come to the TSTU.
4.  The referring ED need NOT write orders for sputum nor write a referral.
5.  IF, the patient is strongly suspected of having active PULMONARY tuberculous disease but is clinically stable following an evaluation in the ED during off-hours, weekends or holidays, the same process may be followed however, the medical provider should call 43077 and leave a voice message indicating that the patient is strongly suspected of having disease.
6.  The TSTU extension is 46058

Please understand that patients presenting with strongly suspected active PULMONARY tuberculosis should be carefully evaluated to reasonably assess that they will return for follow up.  Clinically unstable patients or patients that will likely not follow up with the TSTU following evaluation in the ED on a weekend or holiday should be considered for admission (e.g., homeless person).

During weekdays, cases with a low level of suspicion may be referred to the TSTU in the manner described above.

During weekdays, cases with a high level of suspicion should be called into IPaC at 43077.  The patients can be evaluated in the ED and referred to the TSTU prior to admission.  Admitted patients are evaluated in the same manner and offered the workup in the TSTU with the consent of the medical-surgical admitting team.

regards,

George Alonso, M.D.
Director, Infection Prevention and Control (IPaC)
Elmhurst Hospital Center