Coronavirus

Topics for Case Investigators

Background: This document contains a sample training plan including training topics that may be helpful for state and local public health jurisdictions to consider when designing their own training plan for COVID-19 case investigators. Each heading represents the learning objective for that section. Suggested training modalities/formats are provided, as well as information about sample existing…

Background: This document contains a sample training plan including training topics that may be helpful for state and local public health jurisdictions to consider when designing their own training plan for COVID-19 case investigators. Each heading represents the learning objective for that section. Suggested training modalities/formats are provided, as well as information about sample existing trainings and resources. This document may be updated as new resources become available. For the purposes of this document, case investigators are those who interview confirmed and probable COVID-19 patients and gather information on their recent close contacts.

Overall Training Goal: After completing all training below, learners should be able to conduct basic case investigation according to an established protocol.

Target Audience: Public health employees, volunteers or others with little or no public health disease control experience conducting case investigation.

Identify strategies to reduce spread of COVID-19

  • Background on COVID-19
    • General
    • Epidemiology and surveillance principles
    • Update on current emergency response
  • COVID-19 disease-specific information
    • Signs/symptoms
    • Incubation period and infectious period
    • Testing
    • Diagnosis and current management
    • Prevention and control (including self-isolation for patients and self-quarantine for contacts)
  • Ways to prevent spread of COVID-19
    • General precautions
    • Role of public health, case investigation, and contact tracing
    • Other ways to reduce spread

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Identify the primary components of COVID-19 case investigation

  • Foundational principles of public health
    • General
  • Relevant terminology
    • Case definition
    • Public health jurisdiction’s case investigation terminology
    • Terms that may be used in other jurisdictions (e.g., other states, federal)
  • Introduction to contract tracing
    • General
    • Define contact tracing
    • Describe basic steps of contract tracing
      • Case identification and prioritization
      • Notification of positive test results
      • Interview
      • Follow-up and next steps
    • Describe skills and qualities necessary for case investigators
      • Active listening skills, including the use of open-ended questions
      • Motivational interviewing skills
      • Risk communication, problem solving, emotional intelligence skills
      • Cultural sensitivity
      • Adaptations for patients with communication impairments and non-English speakers

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List requirements for protecting health information

  • Overview of health information privacy/security
    • Why it is important to protect health information
    • Potential consequences if information is not protected
  • Health information privacy and confidentiality
    • Oath of confidentiality, if applicable in the jurisdiction
  • Health information data security
  • Ethics of data collection during an outbreak

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Describe COVID-19 case investigation protocol

  • Describe in detail the actions and requirements associated with each step of the case investigation process at the jurisdiction level
    • Notification of positive test results
    • Interview
      • Explanation of confidentiality
      • Health risk assessment (e.g., signs/symptoms, underlying health conditions)
      • Rationale and instructions for (voluntary) self-isolation
      • Self-isolation tools and supports assessment
      • Identification of contact elicitation window
      • Contact elicitation, including self-referral of contacts and current status of contacts
    • Protocol for workplace/congregate setting exposures (i.e. correctional facilities and shelters)
      • General
      • Implications for contact elicitation
      • Referral to infection control personnel and guidance
    • Follow-up
  • Learn what “a day in the life” of a case investigator looks like by hearing from an experienced case investigator
  • Question-and-answer session

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Apply COVID-19 online knowledge and case investigating protocol to realistic scenarios

  • Review contact tracing protocol
  • Skill-based practice of
    • Introductions and building rapport
    • Disease information and recommendations for seeking healthcare (if symptoms become severe)
    • Open ended questions to elicit close contacts (household, workplace, social, recreational, other community contacts)
  • Apply case investigation protocol to the following scenarios:
    • Case is asymptomatic and doesn’t believe they are infectious
    • Case is asymptomatic and under pressure to continue working
    • Case is under pressure to return to work and symptoms are improving
    • Case is unstably housed
    • Case lives in a household with several other people who cannot distance themselves from the case (share a bathroom, bedroom, kitchen)
    • Case does not want to give you their contacts names or phone numbers.
    • Case is not answering phone calls
    • Suspected case wants to know why they are not being tested and demands a test
    • Case doesn’t understand isolation or how to do it given current life circumstances
    • Case has other challenges (disabled, mental health needs, or substance use challenges) and requires additional supports
    • Case is a health care provider (e.g., emergency room physician, acute care nurse) or works in a congregate setting (e.g., memory care home, group home, homeless shelter, correctional facility)
    • Case is an essential worker with public interfacing position (e.g. grocery checkout clerk) or works in a facility with a large number of people (e.g. food processing facility)
  • Role play with trainer/facilitator feedback
    • General
    • Open ended questions for contact elicitation
    • De-escalation of difficult calls

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Identify jurisdiction-specific case investigation tools

  • Receiving assignments
  • Confidentiality and privacy requirements
  • Use of information systems to collect case data and record case investigation efforts
  • Documenting calls
    • Specifics of local processes and data collection
  • Non-English-speaking contacts
  • Communication-impaired contacts
  • Follow-up resources for cases
  • Field investigations
  • Discussion of how case investigators should share insights from the field – point(s) of contact, regular check-in calls or webinars, online FAQ etc.
  • Resources/referrals for clinical consultation and/or monitoring of cases in high-risk individuals
  • Resources/referrals for special circumstances for case investigation in congregate settings, correctional facilities, workplaces, and shelters
  • Closing out a case

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Analyze case investigation encounters for continuous quality

  • Listening in on calls for quality
  • Using a rubric to document case investigators’ competencies and areas for improvement
  • Follow-up discussion between supervisors and case investigators on difficult cases and methods to improve the quality of the case investigation, data collection, contact elicitation, and experience of case and case investigator
  • Monitoring timeliness, documentation, and outcomes from investigations
  • Learning collaboratives to help case investigators problem solve and learn from each other

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Case investigators sample plan

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