| dc.description.abstract | The Gastroenterology (GI) clinic at Sanford Health anticipates an increase in patients with hepatitis C virus (HCV) based on the 2012 Centers for Disease Control (CDC) screening recommendations. With a disproportionately high prevalence in the baby-boomer population, 75% of all documented HCV cases, the CDC recommended a “one-time testing of all persons born during 1945-1965 without prior ascertainment of HCV risk” (CDC, 2012a).
The purpose of this practice improvement project was to refine the existing workflow of the GI clinic when caring for and managing patients with HCV. The Plan, Do, Study, Act method was followed to improve the processes and address the clinic goals.
The project first assessed the existing referral protocol for hepatitis C to improve the quality of care for HCV patients, to increase the clinic’s efficiency, and to identify opportunities for improvement. HCV is a complicated, intense disease process, necessitating chart reviews, patient education, and depression monitoring. To meet these time commitments the department added a new role, the designated hepatitis C nurse. The hepatitis C nurse would serve as a liaison for all HCV patients and providers.
The assessment further identified an incomplete process within the referral system. During the pre-appointment chart review for new hepatitis C referrals, many required tests were incomplete. To address the gap with referrals from primary care, a brochure containing a hepatitis C screening algorithm was created.
The assessment also identified a need for depression monitoring. To provide safe, up-to-date, treatment monitoring for depression in patients, the Patient Health Questionnaire (PHQ-9) was implemented. The inclusion of PHQ-9 monitoring by the hepatitis C nurse has helped the GI clinic reach its goals for administration compliance.
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Staff members and providers have reported positive impacts at the clinic after the implementation of the new change processes at the GI clinic. Patients have expressed positive satisfaction with the services, particularly the ease of communicating with the GI clinic and consistent personnel since the implementation. | en_US |
