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Infectious Disease Management

Hepatitis C Virus

Guideline Information

Guideline title: Hepatitis C Virus Report and Guidelines

Publication Status: Active

Date of publication: November 2022

Date of last evidence search: 2022

Scope: Metrics, treatment, care coordination, access, expansion of care and treatment settings, models of care, engaging providers 

Methods: Current guidelines and literature review and expert consensus

Description: This guideline is meant to align with existing guidelines from Hep C Free Washington as well as the U.S. Department of Health and Human Services Viral Hepatitis National Strategic Plan. Specifically, guidelines focus on expanding access to HCV services and improving the care cascade through quality metrics, care coordination, adopting non-traditional clinical models, engaging with providers, and embedding HCV services at community sites.

Implementation Checklists by Audience

The checklist tool  translates the Bree guidelines into action steps for that sector. The action items have been arranged into levels 1, 2, and 3 to correspond to the difficulty level of implementing the action into the sectors’ setting. Bree staff co-created the checklists with report workgroup members and topic experts.

Delivery Site and Health System Checklists

Level 1 

Level 2 

Level 3 

Health Care Professional Checklists

Level 1 

Level 2

Level 3 

Health Plan Checklists

Level 1 

Level 2 

Level 3 

Public Health Agency Checklists

Level 1 

Level 2 

Level 3

Resources and Tools

Resources and Tools

Continuing Education Resource

Related Bree Webinars Link

Metrics and Evaluation Tools

Delivery Site and Health Systems

Health System Evaluation Score Card Health System Score Card _ Hep C

Health Care Professionals and Pharmacist

Health Professionals Score Card Health professionals_pharmacists Score Card _ Hep C

Health Plans

Health Plan Score Cards Health Plan Score Card _ Hep C

Washington State Agencies

Washington State Agencies Score Card Public Health Score Card _ Hep C

Guideline Metrics

The work group recommended the Centers for Medicaid and Medicare Services  metric for screening patients for HCV in their measures inventory tool, although the metric is currently not being implemented. The CMS recommended metric is:

  • Percentage of patients age >= 18 years who received one-time antibody screening for hepatitis C virus (HCV) infection
    • Numerator: Patients who received a one-time antibody test for HCV infection
    • Denominator: All patients >= 18 years of age who had at least one preventive visit OR were seen at least twice within the 12-month reporting period. Denominator exceptions: Documentation of medical reason(s) for not receiving one-time screening for HCV infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], waitlist for organ transplant, limited life expectancy, other medical reasons) OR Documentation of patient reason(s) for not receiving one-time screening for HCV infection (e.g., patient declined, other patient reasons)
  • Percentage of patients with a positive RNA HCV test who receive a prescription for direct acting antivirals for HCV.
    • Numerator: Patients who received a prescription for direct acting antivirals for HCV.
    • Denominator: All patients >= 18 years of age who have tested positive for HCV through an RNA test. Denominator exceptions: Avoid duplicate patients who have both a positive antibody and a positive RNA test.

Examples of Implementation - IN DEVELOPMENT

Examples will be added upon review of submissions.

WorkGroup Members

Name Title Organization
Abha Puri, MPH Program Manager Community Health Plan of Washington
Emalie Huriaux, MPH STD, Adult Hepatitis, and Syringe Service Program (SSP) Manager WA Department of Health
John Scott, MD, MSc Professor, Department of Medicine
Medical Director, Telehealth
Associate Medical Director, Liver Clinic		 University of Washington
Jon Stockton, MHA Adult Viral Hepatitis Coordinator WA Department of Health
Judith Tsui, MD, MPH Associate Professor, Department of Medicine
Director, UW Medical Student Addiction Research Program		 University of Washington
Melda Velasquez Service Line Director Kadlec Regional Medical Center
Omar Daoud, PharmD Director of Pharmacy Community Health Plan of Washington
Patrick Judkins Education and Outreach Specialist, Disease Control and Prevention Thurston County Health Department
Ryan Pistoresi, PharmD, MS Assistant Chief Pharmacy Officer Washington State Health Care Authority
Wendy Wong, BSc Ambulatory Clinical Pharmacist Providence Health and Services
Vania Rudolph, MD, MPH Addiction Medicine Specialist Swedish Health Centers
Yumi Ando, MD Gastroenterologist Kaiser Permanente

Award Winners

Award winners for Best Practices in Hepatitis C Virus Care:

Outpatient Infection Control

Guideline Information

Guideline title: Outpatient Infection Control Report and Guidelines

Publication Status: Active

Date of publication: September 2022

Date of last evidence search: 2020

Scope: Preventative measures; monitoring/surveillance; minimizing exposure; environment of care; sterilization and high-level disinfection; community spread.

Methods: Current guidelines and literature review and expert consensus

Description:  This guideline is meant to be applicable to all outpatient (ambulatory) care centers, regardless of specialty.The Washington State Department of Health’s HAI & AR Program is working on defining “outpatient” for the purposes of infection prevention work.

This guideline is meant to supplement existing guidelines from federal, state, and local public health organizations and provide a path forward for outpatient facilities to prioritize IPC activities. Specific focus areas discussed in this guideline include prevention, surveillance, minimizing exposure, environment of care, sterilization and high–level disinfection, and community spread. Guidelines are directed toward:
• Outpatient health delivery systems
• Employers as IPC providers and health care purchasers
• Health insurance plans
• Public health agencies
• Those receiving care (patients/consumers)

Implementation Checklists by Audience

The checklist tool  translates the Bree guidelines into action steps for that sector. The action items have been arranged into levels 1, 2, and 3 to correspond to the difficulty level of implementing the action into the sectors’ setting. Bree staff co-created the checklists with report workgroup members and topic experts.

Delivery Site and Health System Checklists

Level 1

Level 2

Level 3

Health Care Professional Checklists

Level 1

Level 2

Level 3

Public Health Agency Checklists

Level 1

Level 2

Level 3

Metrics and Evaluation Tools

Delivery Site and Health Systems

Health System Evaluation Score Card Health System Score Card _ OPIC

Patient Education Evaluation Score Card Patient Education Score Card _ OPIC

Health Care Professionals

Clinician Evaluation Score Card Clinician Evaluation Score Card _ OPIC

Health Plans

Health Plan Evaluation Score Card Clinician Evaluation Score Card _ OPIC

Washington State Agencies

Public Health Evaluation Score Card Public Health Score Card _ OPIC

Health care employers and Private Organizations

Health Care Employer/Community Organization Evaluation Score Card Employer Evaluation Score Card _OPIC

Guidelines Metrics

Common metrics that are reportable to a state or national entity for infection prevention in the outpatient setting do not currently exists. The Bree report recommends minimum expectations for safer care from the CDC’s 2016 Guide to Infection Prevention for Outpatient Settings, which include:
• Dedicate administrative resources to IPC
• Educate and train healthcare personnel
• Monitor and report healthcare–associated infections
• Adhere to standard precautions (hand hygiene, personal protective equipment, safe injection practices, safe handling of potentially contaminated equipment, and respiratory hygiene)

Organization specific operational measures to help guide implementation and monitoring of activities have been developed by the Bree Collaborative, in collaboration with the Washington State Department of Health and Seattle Children’s IP specialists to help organizations measures their progress on best practices.

CDC’s Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings

Workgroup Members

Name Title Organization
Mark Haugen, MD (chair) Family Medicine Physician Walla Walla Clinic & Surgical Center
Anne Sumner, BSN, MBA VP Head of Operations Baker Boyer Bank
Cathy Carroll Washington Health Care Authority
Faiza Zafar, DO, FACOI Medical Director Community Health Plan of Washington
Larissa Lewis, MPH, CIC HAI Education and Guidance Development Supervisor WA Department of Health
Lisa Hannah, RN, CIC Infection Prevention Team Supervisor WA Department of Health
Lisa Waldowski, DNP, CIC Regional Director, Infection Prevention and Control Kaiser Permanente
Rhonda Bowen, CIC, CPPS, CPHQ Senior Improvement Advisory, Patient Safety Comagine Health
Stephanie Jaross, BSN, RN ASC Director Proliance Center for Outpatient Spine and Joint Surgery
Sierra Bertolone-Smith, MDc Medical Student Pacific Northwest University of Health Sciences

Award Winners

Award winners for Best Practices in Outpatient Infection Control:

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