Liver Health Event: An Innovative Approach To Improve Hepatitis C Screening And Linkage To Care In Indigeneous Communities

Author: Reed N, Pandey M, Skinner S, Lafond D Nicodemus A

Theme: Epidemiology & Public Health Research Year: 2017

Background: Hepatitis C (HCV) is a chronic disease that disproportionately affects Indigenous people. Geography, stigma, discrimination and previous negative experiences with mainstream healthcare services are major barriers leading to underutilization of healthcare services by Indigenous people. With guidance from a community a Liver Health Event (LHE) was hosted in an Indigenous community to initiate HCV screening in a culturally safe environment. Each LHE was followed up by a clinic to address clients’ needs for HCV treatment eligibility.

The objective of the project was to examine the effectiveness of the LHE in improving access to HCV testing and linkage to care in the community.

Methods: Employing a mixed methods design collaborative discussion with Elders and clients helped address the stigma and identified need for a community-based program. A patient workflow was developed by a team of nine healthcare providers, coached by a Lean Consultant to process 60 patients in 300 minutes.

Results: One new patient was registered every 5 minutes. Each healthcare professional completed their process in 5 minutes, thereby minimizing patient wait-times and attaining the screening target. Education sessions helped manage patient flow, reducing backlogs to oral swabs, fibroscans or phlebotomy. Sixty patients were screened and educated, 54 patients were reviewed and fibro scanned, 25 received oral swabs, 35 received phlebotomy, 30 received counselling, 12 received flu vaccination. Food and door prizes were provided for all registered.

Conclusions: Community consultation and support from community leadership was crucial in promoting and developing the LHE. By providing screening, fibroscan, phlebotomy, counselling and education in one place, patient flow was improved significantly while ensuring better linkage to care. Onsite education dispelled myths about HCV; and provided information about prevention, reinfection and available treatment. This innovative health intervention was an effective way to improve access to HCV screening and treatment in remote Indigenous communities.

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