Clinical Scorecard: Screening for Hepatitis C Virus in Surgical Patients at a Tertiary Care Facility in Northern China
At a Glance
Category
Detail
Condition
Chronic Hepatitis C Virus (HCV) infection
Key Mechanisms
Asymptomatic chronic infection leading to low detection; diagnosis via anti-HCV antibody screening and confirmatory HCV RNA testing
Target Population
Surgical patients undergoing preoperative screening at a tertiary care hospital
Care Setting
Tertiary academic medical center with integrated electronic health records
Key Highlights
Implementation of a standardized HCV micro-elimination program with universal antibody screening, physician-mandated RNA testing within 72 hours, and mandatory specialist referral during hospitalization.
Large cohort study of 114,968 surgical patients from multiple departments with rigorous data validation showing >98% concordance.
Identification of critical failure points in the HCV care cascade, particularly RNA testing completion and linkage to hepatology care before discharge.
Guideline-Based Recommendations
Diagnosis
Universal anti-HCV antibody screening for all eligible hospital admissions.
Confirmatory HCV RNA testing ordered by attending physician within 72 hours of positive antibody result.
Management
Mandatory in-hospital referral to Hepatology or Infectious Diseases for patients with confirmed HCV RNA positivity.
Use of a centralized registry and real-time compliance monitoring to ensure adherence to testing and referral protocols.
Monitoring & Follow-up
Continuous tracking of physician order placement for RNA testing and specialist referral within stipulated timeframes before patient discharge.
Manual audit of electronic health records to verify data accuracy and protocol adherence.
Risks
Delayed or missed RNA testing leading to failure in confirming active infection.
Lack of specialist referral during index hospitalization potentially delaying treatment initiation.
Early identification through the care cascade facilitates timely linkage to specialist care, critical for initiating curative direct-acting antiviral therapy and achieving WHO elimination targets.
Clinical Best Practices
Incorporate universal anti-HCV antibody screening into standard admission protocols for surgical patients.
Enforce strict timelines (≤72 hours) for confirmatory HCV RNA testing orders following positive antibody results.
Ensure mandatory specialist referral orders are placed during the index hospitalization for RNA-positive patients.
Utilize integrated electronic health records and centralized registries for real-time compliance monitoring and patient tracking.
Conduct regular audits of medical records to maintain data integrity and identify gaps in the care cascade.
