SHM Converge Scientific Abstract ePoster Gallery-A Quality Improvement Tool to Improve Hepatocellular Carcinoma Screening Adherence

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This quality improvement project aimed to improve adherence to hepatocellular carcinoma (HCC) screening in patients with cirrhosis at Indiana University School of Medicine–Southwest in Evansville. Because HCC is a leading cause of cancer-related death, current AASLD guidelines recommend liver ultrasound screening every 6 months for cirrhotic patients.<br /><br />Before the intervention, overall screening adherence was 55%, slightly above the national average of 52%, but 32% of patients had suboptimal screening intervals. These gaps ranged from 7 to 42 months between ultrasounds, indicating significant delays in surveillance.<br /><br />The team created a simple tracking and alert system. Patients with cirrhosis were identified using ICD-10 codes, and those without an up-to-date liver ultrasound were flagged. Providers received an alert to order screening, followed by a second alert one week later if no ultrasound had been ordered. The patient list was reviewed weekly, and it was updated for deaths, loss to follow-up, and new HCC diagnoses.<br /><br />After the intervention, screening intervals improved substantially. The longest gap between ultrasounds decreased to 20 months, showing better consistency in surveillance. The authors note that since the abstract was accepted, 13 patients were removed from the active cohort because of death, loss to follow-up, or new HCC diagnosis. They expect further improvement as more patients reach the 6- and 12-month follow-up points.<br /><br />Overall, the project suggests that a structured reminder system and regular monitoring can improve the quality and timeliness of HCC screening in a cirrhosis population.

Asset Subtitle

Jessica Sosio

Meta Tag

Author List Adrian Singson, Jessica Sosio, Karla Geisse, Konstantin Boroda, Niamh McKee

Category Research

Concept Hepatocellular Carcinoma

Concept Cirrhosis

Concept Cancer Surveillance

Concept Ultrasound Screening

Concept Screening Adherence

Distinguished Non-Finalist

Presenter Organization Indiana University

Presenting Author Jessica Sosio

Track Quality Improvement

Keywords

hepatocellular carcinoma

HCC screening

cirrhosis

liver ultrasound

AASLD guidelines

screening adherence

quality improvement

reminder system

surveillance intervals

Indiana University School of Medicine

Hepatocellular Carcinoma

Cirrhosis

Cancer Surveillance

Ultrasound Screening

Screening Adherence