TB Notes Newsletter
No. 4, 2007
HIGHLIGHTS FROM STATE AND LOCAL PROGRAMS
Delaware’s Lang TB Clinic Team Selected as Finalist for
the Governor’s 2006 Team Excellence Award
In an average year, the Lang TB Clinic at the
Hudson State Service Center in Newark, Delaware, will conduct 16
to 18 contact investigations, provide directly observed therapy
(DOT) for all TB patients, and each month will provide preventive
treatment for another 250–300 Delawareans with latent TB infection
(LTBI). Most of their clients are among the most underserved and
vulnerable in the state: low income, non-English speaking Hispanics,
blacks, foreign-born persons, and undocumented immigrants. The Lang
Clinic team, composed of three nurses, an outreach worker, and support
staff, handle this workload with great aplomb.
In 2006, Jeannie Rodman, MSN, RN, program nurse
consultant, decided to submit a nomination for the second annual
Delaware Governor’s Team Excellence Award based on their efforts
during a contact investigation.
Delaware Governor’s Team Excellence Award honors the efforts
of teams of 6 or more individuals from the state’s workforce
of approximately 12,000 full-time employees. Of the 26 teams entered,
five finalists received special honors. The Lang Clinic Team was
recognized as a finalist, at a ceremony held on July 21, 2007, in
“The Delaware Governor’s Team Excellence
Award criteria are very specific, with a definite slant toward the
sort of effort that can be showcased with lots of charts and graphs,”
said Ms. Rodman. “I knew we would be up against some very
sophisticated efforts, and wondered if we had a chance against that
sort of razzle-dazzle. What we do is not glamorous, but it is
the essence of public service, and we had some amazing results.
This particular effort was complicated by the need to incorporate
two important newer roles in Delaware’s Division of Public
Health (DPH) – that of the Medical Director and the Office
of Health Risk Communication, in response to media attention.”
This particular team effort centered around a
challenging contact investigation that began in June 2006, when
a kitchen worker in a popular Wilmington-area restaurant was diagnosed
with active TB. The worker, a non-English speaking Hispanic male,
had been ill for many months. Close contacts, including co-workers,
family, and friends, numbered more than 100. Within 3 weeks, in
spite of language and potential trust barriers, all contacts had
been screened, including chest x-rays for those at highest risk.
High-risk contacts were placed on preventive therapy, and the source
patient was on his way to recovery. Thanks to a quick and effective
response of the team, no disease transmission is known to have occurred.
TB Clinic Team (left to right): Jacqueline Holland, RN, BSN; Katherine
Deitcher, RN, BSN; Marie O’Leary, RN, BSN, Nursing
Supervisor; Nila Boone, Social Services Specialist; Nilda Martinez,
Social Service Technician; and Susan Keegan, RN, BSN, Clinic Manager.
Not pictured are Marcia Brinker, RN, BSN, and John Chabalko, MD,
The investigation was complicated when a family
member of the restaurant employee called the local newspaper, igniting
a storm of media attention. The clinic’s response to this
challenge involved dozens of e-mails and last-minute conference
calls with DPH leadership and the Office of Health Risk Communications
(OHRC), wedged between the usual business of the clinic and the
extraordinary effort involved in the investigation. The team emerged
from the crisis having helped develop a decision tree regarding
lines of communication and responsibility within the DPH leadership,
which in turn led to an updated communications policy.
This cohesive and talented team serves as a testament
to the leadership of Nursing Supervisor Marie O’Leary, RN,
and Clinic Manager Susan Keegan, RN. New Castle County Public Health
competes for nurses with the large health care systems of the Wilmington
and Philadelphia area, yet the Lang TB Clinic manages to maintain
a savvy, well-educated, and energized team of professionals. Ms.
O’Leary accomplishes this by fostering an atmosphere of trust
and by engaging team members with her passion and fascination for
the complexities of the disease and a devotion to excellence.
by Jeannie Rodman, MSN, RN
Tuberculosis Nurse Consultant
Delaware Division of Public Health