Increasing hepatitis C screening and referral within an FQHC look-alike, primary care setting: A quality improvement project

Hepatitis C virus (HCV) is a liver disease brought on by a viral infection that presents few or no symptoms during an acute infection (CDC, 2024). Chronic HCV infection can result in irreversible liver damage, such as cirrhosis or hepatic carcinoma (Moyer et al., 2013). Although there is no current preventative vaccine, there are treatment options that can cure the host of the virus (CDC, 2024). Research has shown that screening for hepatitis C in the primary care setting, based on risk factors, has been an effective method for early detection (Layman, et. al., 2020; Perkins, et. al., 2021; and Zuure, et al., 2010). To date, there has been a lack of screening for HCV due to the absence of a screening protocol or procedure in place at a small community health center in Springfield, Ohio. Current recommendations available by several health organizations, including the CDC, WHO, and USPSTF, propose a gold standard of care, which is to screen all adults, 18 years and older, and more often if considered a patient at high risk of infection (Layman, et. al., 2020 and Moyer, 2013). The purpose of this project is to improve screening and referral rates for HCV infection at a small community health facility by implementing an HCV risk assessment tool into the Electronic Health Record system (EHR). The objective of this quality improvement project is to increase hepatitis C screening from 0% to 60% within a 4-week implementation period. WHO estimated that 242,000 people died in 2022 from severe liver disease related to HCV infection. WHO has a goal to end HCV by 2030. Clark County Combined Health District reports from 2024 indicate rising numbers of HCV infection, with sixty-seven reported cases year to date, fifty-nine reported cases in 2023 (Clark, 2024). Improving HCV screening through risk-based assessment will not only improve patient outcomes but assist in reaching the WHO goal of HCV eradication by 2030.