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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

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Use of a Hepatitis C Screening Order Set to Improve Screening Rates and Measure Intervention Effectiveness.

Victoria L Prince¹, Sean McNamara¹, Ken Gondor¹

¹University of Utah Department of Family and Preventive Medicine, University of Utah Medical School, Salt Lake City, UT.

Primer (Leawood, Kan.)

|June 16, 2020

Summary

Implementing an order set for Hepatitis C virus (HCV) screening, allowing medical assistants to order labs, improved screening rates in a family medicine clinic. This intervention provides a measurable process for future quality improvement initiatives.

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Published on: December 21, 2019

Area of Science:

Hepatology
Public Health
Healthcare Quality Improvement

Background:

Hepatitis C virus (HCV) infection poses significant health risks, particularly for individuals born between 1945-1965.
The Centers for Disease Control and Prevention recommends universal screening for this demographic.
Previous electronic medical record (EMR) interventions have shown promise but room for improvement remains.

Purpose of the Study:

To enhance Hepatitis C virus (HCV) screening rates within a family medicine clinic.
To implement a team-based, continuous quality improvement (CQI) intervention.
To leverage EMR capabilities for improved patient care.

Main Methods:

A family medicine resident-led CQI team utilized the Model for Improvement.
An EMR order set was developed, enabling medical assistants and phlebotomists to order HCV screening labs.
Data on screening rates and order set utilization were extracted from the EMR.

Main Results:

HCV screening rates at Madsen Family Medicine Clinic increased from approximately 40% to over 50% within a 5-month period.
The intervention order set was used 19 times, contributing to 18.8% of new HCV screens.
The intervention demonstrated a measurable increase in screening efficiency.

Conclusions:

Empowering medical assistants with an order set to initiate HCV screening labs effectively boosts screening rates.
EMR-extracted utilization data provides a valuable process measure to assess intervention effectiveness.
This intervention offers a scalable model for improving HCV screening in primary care settings.