2025 UNIVANTS of Healthcare Excellence Award: Nine innovative teams earn recognition

TBI strategies: Expediting patient flow and reducing length of stay through blood biomarker–guided management of patients with suspected mild traumatic brain injury

An integrated clinical care team from Clermont-Ferrand, France, recognized that patients who present to the emergency department (ED) with a traumatic brain injury (TBI) often require a CT scan, which is typically conducted between 4-8 hours after the injury. For patients with mild TBI (mTBI), the incidence of complications is low and thus CT scans are often negative. Consequently, patients can spend substantial time waiting for imaging, compounding ED overcrowding, while being exposed to potentially unnecessary radiation from the CT scan.

With a strong understanding of existing evidence, this integrated clinical care team sought to improve patient flow in the (ED), while reducing length of stay through implementation of a brain biomarker– guided decision pathway to reduce unnecessary CT scans. Their collaborative effort reduced length of stay for mTBI patients by over 3 hours, thus mitigating 2,300 resource hours each year from medical and non-medical staff­ as a direct result of expedited patient flow.

The pathway to HCV elimination: Multidisciplinary team effort for improved identification, diagnosis, and treatment of HCV positive patients

Early identification of hepatitis C is a globally relevant and important goal, with the World Health Organization (WHO) global hepatitis strategy aiming to achieve a 90% reduction in new infections and 65% reduction in deaths by 2030.³ In Japan, an estimated 1.0–1.5 million people have undiagnosed and/or untreated hepatitis C (HCV) infections.⁴ The Musashino Red Cross Hospital is a regional core center for liver disease treatment in Tokyo, with initiatives that actively promote and work toward hepatitis elimination, including enhanced recommendations for screening, follow-up, and consultation for patients who test positive for HCV antibodies, in addition to e-alert systems to further encourage clinical action.

Recognizing that identification of patients with untreated HCV requires multi-faceted initiatives, the Musashino Red Cross Hospital built upon their previous best practices to implement new processes for follow-up that link patients to care and treatment.

This multi-disciplinary initiative involved laboratory medicine, doctors, nurses, and administrative sta­ff and has reduced the unreferred rate for patients with HCV antibody positivity by 33.7% [from 34.8% (2020) to 1.1% (2024)] and led to an 8.3% reduction [from 10.2% (2022) to 1.9% (2024)] in the number of known HCV positive patients without treatment. Impressively, clinicians in other departments have also changed their behavior thanks to comprehensive educational efforts, enabling a 6.2% increase [from 17.5% (2022) to 23.7% (2023)] in clinical adherence to hospital recommendations for medical history checks, relevant HCV antibody testing and subsequent referrals, as appropriate. Collectively, these e­fforts are mitigating preventable liver cancers, with mitigated costs of approximately 46.4 million yen/year.

Radiation reduction: Increased safety and improved length of stay for patients with suspected mild traumatic brain injury in the emergency department

The importance of TBI management is evident, with a second team receiving top recognition in 2025 for their brain biomarker–guided decision pathway. The integrated clinical care team from Santa Cruz de Tenerife, Spain, recognized that most of their patients with mTBIs spend an average of 8.7 hours in the ED waiting, and they are often discharged without the need for significant intervention. With the goal of reducing unnecessary radiation and improving length of stay, this integrated clinical care team incorporated glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCHL-1), into their decision-making pathway to help rule-out the need for CT scans for patients with suspected mTBI.

Since implementation in 2022, this integrated clinical care team has evaluated over 5,000 patients in the ED for mTBI, with an impressive 36% of mTBI patients safely avoiding unnecessary CT scans. This has further enabled a 4.23 hour reduction in ED length of stay for patients who do not require observation.

Congratulations to the top winning care teams and to all integrated clinical care teams receiving recognition in 2025! For more information on UNIVANTS, the 2025 winners, and/or to apply starting August 1^st, please visit www.UnivantsHCE.com.

References

1. Strain C, Ravalico T. Electric trends of laboratory medicine: Five years of growth, visibility, and opportunity. J Appl Lab Med. 2025;10(2):440-454. doi:10.1093/jalm/jfae152.
2. The UNIVANTS of Healthcare Excellence award program. The UNIVANTS program. Accessed June 25, 2025. www.UnivantsHCE.com.
3. Hepatitis. World Health Organization (WHO). Accessed June 25, 2025. https://www.who.int/health-topics/hepatitis/elimination-of-hepatitis-by-2030#tab=tab_1.
4. Tanaka J, Kurisu A, Ohara M, et al. Burden of chronic hepatitis B and C infections in 2015 and future trends in Japan: A simulation study. Lancet Reg Health West Pac. 2022;22:100428. doi:10.1016/j.lanwpc.2022.100428.