Tierney D B, Nathavitharana R R, Cummins L, Tintaya K, Biewer A, Guerrero R, Lecca L, Hirschhorn L R, Nardell E A, Nelson A K
Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Public Health Action. 2025 Jun 4;15(2):1-16. doi: 10.5588/pha.24.0055. eCollection 2025 Jun.
The FAST (Find cases Actively, Separate safely and Treat effectively) TB infection control (TB-IC) strategy decreases the time-to-TB diagnosis and treatment. We examined healthcare workers' (HCW) perceptions of FAST implementation at a tertiary referral hospital in Lima, Peru.
From August 2016 to December 2019, we conducted 24 interviews and four focus groups ( = 14) with a diverse population of HCWs and other stakeholders involved throughout the TB care cascade. We used inductive analysis to identify emergent themes, used Dedoose to code transcripts accordingly, and developed a narrative using reflexive thematic analysis.
We identified three emergent themes: 1) FAST impact on TB care, 2) FAST impact on TB-IC and 3) FAST impact on hospital culture. FAST was felt to improve the speed of TB screening, diagnosis and treatment. TB specialists recognized that by expediting diagnosis and treatment, FAST likely decreased transmission. Healthcare workers appreciated that FAST improved care coordination along the TB care cascade. FAST changed hospital culture related to the prioritization of TB-IC.
HCWs perceived that FAST, implemented by a dedicated external team, was an acceptable and effective TB-IC strategy that improved care coordination and overall TB quality of care.
FAST(积极发现病例、安全隔离和有效治疗)结核病感染控制(TB-IC)策略缩短了结核病诊断和治疗的时间。我们调查了秘鲁利马一家三级转诊医院的医护人员对FAST实施情况的看法。
2016年8月至2019年12月,我们对参与结核病治疗全过程的不同医护人员群体和其他利益相关者进行了24次访谈和4次焦点小组讨论(n = 14)。我们采用归纳分析法确定新出现的主题,使用Dedoose对访谈记录进行编码,并运用反思性主题分析法撰写了一篇叙述文。
我们确定了三个新出现的主题:1)FAST对结核病治疗的影响,2)FAST对TB-IC的影响,3)FAST对医院文化的影响。人们认为FAST提高了结核病筛查、诊断和治疗的速度。结核病专家认识到,通过加快诊断和治疗,FAST可能减少了传播。医护人员赞赏FAST改善了结核病治疗全过程的护理协调。FAST改变了与TB-IC优先排序相关的医院文化。
医护人员认为,由一个专门的外部团队实施的FAST是一种可接受且有效的TB-IC策略,它改善了护理协调和整体结核病护理质量。