66 Improvement in the outcome of the viral hepatitis prevention program at national guard hospitals (riyadh) in 2018. (25th October 2019)

• Record Type: Journal Article
• Authors: Nouf, Al Eniz; Turkstani, Abrar; Ameer, Kholoud Al; Almunif, Sara; Shamrani, Majed Al; Balkhy, Hanan; Ramadan, Aiman
• Is Part Of: BMJ open quality. Volume 8:Supplement 1(2019)
• Page Start: A28
• Page End: A29
• Publication Date: 2019-10-25
• Subjects: Medical care -- Quality control -- Periodicals; 362.106805
• DOI: 10.1136/bmjoq-2019-PSF.66
• Languages: English
• ISSNs: 2399-6641

Abstract

Abstract : Background: The public health team of the Infection Prevention and Control (IPC) department conducted a systemic evaluation in 2017 for patients diagnosed with hepatitis B or C between 2013 and 2016. The findings showed high rates of loss to follow-up and unreachable viral hepatitis B and C infected cases. Loss to follow-up has been shown to be a major obstacle for management of patients with hepatitis. The objective of the current study was to improve the rate of case identification and follow-up management. Methods: To improve the rate of case identification and follow-up management, the guidelines for viral hepatitis were upgraded in 2018 by IPC staff after active engagement of head and treating physicians of relevant departments and hospital executives. Additionally, key performance improvement (KPI) metrics were established: loss to follow-up (unable to reach patient) and increase in management initiation (able to reach and counsel patient). Data for patients with positive HBsAg and HCV PCR were collected in 2018 using the hospital electronic record system. In addition to enhanced counselling and referral of infected patients, an annual viral hepatitis awareness campaign was done during the International Hepatitis Day to raise public awareness about vaccination and treatment for viral hepatitis. Results: Hepatitis B management initiation increased from 67% during 2013–2016 to 94% during 2018, and patients lost to follow- up decreased from 33% to 6%. Similarly, hepatitis C management initiation increased from 67% during 2013–2016 to 86% during 2018, and patients lost to follow up decreased from 33% to 14%. Conclusion: Enhanced counselling and referral of infected patients, and increasing public awareness were successful in improving the initiation of case management and reducing loss to follow-up for patients with hepatitis B and C. The intervention focused on engagement and use of the hospital electronic record system in improving the public health role of the IPC department. More efforts are still required to reduce the number of patients lost to follow-up.