Dissemination of Universal Genetic Testing to Three Unique Oncology Care Settings

Authors:

Erica Bednar (Presenter)
The University of Texas MD Anderson Cancer Center

Kimberly Muse, The University of Texas MD Anderson Cancer Center
Holly Oakley, The University of Texas MD Anderson Cancer Center
Ellen Baker, The University of Texas MD Anderson Cancer Center
Rebekah Krukenberg, Community Health Network
Cara Dresbold, Community Health Network
Sandra Jenkinson, Community Health Network
Nichole Morman, OhioHealth
Elizabeth Bowdish, OhioHealth
Julia Cooper, OhioHealth
Emaline Wise, OhioHealth
Amanda Eppolito, Piedmont Healthcare
Kelly Teed, Piedmont Healthcare
Molly Klein, Piedmont Healthcare
Han Chao, Emory University School of Medicine
Michael Method, Community Health Network
Andrew Grainger, OhioHealth
Deepa Halaharvi, OhioHealth
Kellie Rath, OhioHealth
William Wise, OhioHealth
John Henson, Piedmont Healthcare
Amanda Morehouse, Piedmont Healthcare
Erin Bowman, Piedmont Healthcare
Banu Arun, The University of Texas MD Anderson Cancer Center
Karen Lu, The University of Texas MD Anderson Cancer Center

Public Health Statement: Provision of genetic counseling (GC) and genetic testing (GT) to identify underlying BRCA1 and BRCA2 mutations can guide cancer treatment, screening, and prevention in patients with cancer and their families.

Purpose: Following a successful quality improvement (QI) initiative to increase GC/GT of patients with breast and ovarian cancer to >80% at our institution, we describe the dissemination of the QI project to three oncology care settings (OCS).

Methods/Approach: The OCS are members of our institution’s hospital network, were strategically identified, and agreed to participate. Project teams were built at all sites, led by genetic counselors. An environmental scan was created to assess OCS structure, resources, and GC/GT processes. Teams at each OCS completed the scan and a semi-structured interview; from which, barriers to patients accessing GC/GT were identified. The QI project follows the Plan-Do-Study-Act cycle model. A database was built for analysis of patients diagnosed between 2015 and 2019 with ovarian cancer and triple negative breast cancer.

Results: Although unique barriers were identified at each OCS, all noted patient referral/scheduling issues, technology and electronic medical record system inefficiencies, and inconsistent physician referral/GT practices. Clinical QI interventions were designed to address specific barriers. The OCS-specific interventions include: physician-coordinated GT, GC within chemo infusion suites, physician education sessions, GC scheduling improvements, patient education documents, and referral tracking processes.

Conclusions/Implications: Utilizing an established hospital network, genetic counselors collaborated and disseminated a QI project to improve GC/GT access and utilization at three unique OCS. QI interventions were developed to address the unique environment and barriers at each OCS.