HEPATITIS C SCREENING IN PREGNANCY: A SINGLE CENTER QUALITY IMPROVEMENT EXPERIENCE

Document Type

Conference Proceeding

Publication Date

10-1-2022

Publication Title

Hepatology

Abstract

Background: Hepatitis C infection is a major cause of liver disease with more than half of patients developing chronic infection if infected. According to the CDC, an estimated 57,500 acute Hepatitis C occurred in the United States in 2019. National data revealed an increase in reported cases of HCV infection every year from 2009 to 2017. Among these patients, the highest rates were in people aged 20-39. The CDC and AASLD-IDSA recommend Hepatitis C screening for everyone at least once in their lifetime and for all pregnant women during each pregnancy regardless of risk factors. We conducted a quality improvement project in our hospital to assess Hepatitis C screening among pregnant women. Our objective was to assess compliance with CDC and AASLD-IDSA recommendations for Hepatitis C screening in pregnant women and evaluate ways to improve it. Methods: We gathered data from all pregnant women who presented to Toledo hospital for delivery from September 2020 to May 2021. A total of 2735 patients were included, among these, only 63 patients had been screened for Hepatitis C. We reached out to all our obstetrics and gynecology providers via email prompting them to screen pregnant patients for Hepatitis C during their care. We also educated patients on the importance of Hepatitis C screening and the effects of both acute and chronic HCV infection on the child and mother, encouraging them to request screening if not offered. Printed handouts regarding Hepatitis C screening were distributed to the patients. We later ran another data analysis report in Epic for all pregnant patients between June 2021 to March 2022, which showed 3161 patients presented to hospital for delivery and among them 121 had been screened for Hepatitis C. Results: A chi-square analysis was performed which showed chi-square statistic (x2) 11.271 with a p value of 0.001 indicating significant results. We also requested that our Epic IT team introduce an EPIC Hard Stop protocol for Hepatitis C when pregnant women present for their initial visit and recommended Hepatitis C screening to be made a part of their obstetrical triage order panel. We also encouraged all providers to refer all Hepatitis C positive patients to GI to establish care for Hepatitis C treatment. Overall, a 65% increase in screening for Hepatitis C among pregnant women was observed after implementing our Hepatitis C screening protocol. Conclusion: Hepatitis C screening is recommended in all pregnant women during pregnancy. Through our hepatitis C screening intervention and by implementing the changes listed we were able to significantly improve hepatitis C screening in pregnant patients presenting to Toledo hospital.

Volume

76

First Page

S376

Last Page

S377

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