J Genet Couns. 2018 May 16. doi: 10.1007/s10897-018-0262-4. [Epub ahead of print]
Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings.
Bednar EM1,2, Walsh MT Jr3, Baker E3, Muse KI4, Oakley HD4, Krukenberg RC5, Dresbold CS5, Jenkinson SB5, Eppolito AL6, Teed KB6, Klein MH6, Morman NA7, Bowdish EC7, Russ P7, Wise EE7, Cooper JN7, Method MW8, Henson JW6, Grainger AV9, Arun BK10, Lu KH11.
An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.
Cancer genetics; Environmental scan; Genetic counseling; Genetic testing; Health systems; Hereditary cancer; Quality improvement