Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations
Abstract Objective The interactions among hepatitis C virus (HCV), human immunodeficiency virus (HIV), and the ongoing injection drug epidemic have created a syndemic that significantly affects the Appalachian region of the United States. The purpose of this work is to describe a successful Kentucky...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12866 |
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| author | Barbra Cave Kimberly Laun Brianna Sheahan Ashlee Melendez Adam Ross |
| author_facet | Barbra Cave Kimberly Laun Brianna Sheahan Ashlee Melendez Adam Ross |
| author_sort | Barbra Cave |
| collection | DOAJ |
| description | Abstract Objective The interactions among hepatitis C virus (HCV), human immunodeficiency virus (HIV), and the ongoing injection drug epidemic have created a syndemic that significantly affects the Appalachian region of the United States. The purpose of this work is to describe a successful Kentucky program that aimed to increase HCV and HIV testing for people visiting an urban emergency department (ED) who were screened, diagnosed, and linked to care after diagnosis with special consideration for substance use disorder. Methods The Plan‐Do‐Study‐Act model for quality improvement was used to create a streamlined process for testing, reporting results, and linking people to care. The program was refined and expanded across 3 phases. Results Across all phases, a total of 25,685 patients were eligible for testing and did not opt out. Of those, 17,090 had HCV antibody (Ab) testing; 3460 (20.2%) had HCV Ab; 1750 (50.8%) had HCV RNA, and an average of 31% of patients were linked to care within 30 days. The program found 54 new cases of HIV infection. Conclusions Universal HCV and HIV testing and linkage to care is possible within an ED. In areas affected by the syndemic, EDs may serve as a public health safety net to identify affected individuals and ensure they receive follow‐up care. Testing in this center uncovered an exceptionally high prevalence of HCV infection and new HIV case identification. |
| format | Article |
| id | doaj-art-b362f0a5292546cea88a7df3ccbb6dc4 |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-b362f0a5292546cea88a7df3ccbb6dc42025-08-20T01:55:41ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-12-0136n/an/a10.1002/emp2.12866Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendationsBarbra Cave0Kimberly Laun1Brianna Sheahan2Ashlee Melendez3Adam Ross4Department of MedicineUniversity of Louisville LouisvilleKentuckyUSADepartment of MedicineUniversity of Louisville LouisvilleKentuckyUSAEmergency DepartmentUofL Health Hospital LouisvilleKentuckyUSADepartment of MedicineUniversity of Louisville LouisvilleKentuckyUSADepartment of MedicineUniversity of Louisville LouisvilleKentuckyUSAAbstract Objective The interactions among hepatitis C virus (HCV), human immunodeficiency virus (HIV), and the ongoing injection drug epidemic have created a syndemic that significantly affects the Appalachian region of the United States. The purpose of this work is to describe a successful Kentucky program that aimed to increase HCV and HIV testing for people visiting an urban emergency department (ED) who were screened, diagnosed, and linked to care after diagnosis with special consideration for substance use disorder. Methods The Plan‐Do‐Study‐Act model for quality improvement was used to create a streamlined process for testing, reporting results, and linking people to care. The program was refined and expanded across 3 phases. Results Across all phases, a total of 25,685 patients were eligible for testing and did not opt out. Of those, 17,090 had HCV antibody (Ab) testing; 3460 (20.2%) had HCV Ab; 1750 (50.8%) had HCV RNA, and an average of 31% of patients were linked to care within 30 days. The program found 54 new cases of HIV infection. Conclusions Universal HCV and HIV testing and linkage to care is possible within an ED. In areas affected by the syndemic, EDs may serve as a public health safety net to identify affected individuals and ensure they receive follow‐up care. Testing in this center uncovered an exceptionally high prevalence of HCV infection and new HIV case identification.https://doi.org/10.1002/emp2.12866emergency departmenthepatitis CHIVsyndemicuniversal screeninguniversal testing |
| spellingShingle | Barbra Cave Kimberly Laun Brianna Sheahan Ashlee Melendez Adam Ross Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations Journal of the American College of Emergency Physicians Open emergency department hepatitis C HIV syndemic universal screening universal testing |
| title | Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| title_full | Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| title_fullStr | Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| title_full_unstemmed | Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| title_short | Aligning an emergency department hepatitis C and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| title_sort | aligning an emergency department hepatitis c and human immunodeficiency virus testing quality improvement initiative with universal screening recommendations |
| topic | emergency department hepatitis C HIV syndemic universal screening universal testing |
| url | https://doi.org/10.1002/emp2.12866 |
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