Faculty Collaboration Database

Implementation of a quality improvement project for universal genetic testing in women with ovarian cancer. Gynecol Oncol 2018 Jun;149(3):565-569

Date

04/15/2018

Pubmed ID

29653687

DOI

10.1016/j.ygyno.2018.03.059

Scopus ID

2-s2.0-85045079578 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

OBJECTIVE: The National Comprehensive Cancer Network recommends all women with ovarian cancer be offered genetic testing. Despite a decade of endorsement, many oncology practitioners have yet to make this a part of routine practice. Referral to genetic counseling and completion of genetic testing among patients at substantial risk of germline mutations are significantly lacking, adversely affecting patient care and squandering an opportunity to maximize cancer prevention efforts. This project determined the impact and feasibility of implementing a basic model for universal referral to genetic counseling and completion of genetic testing in women with a diagnosis of ovarian cancer in an academic gynecology oncology practice with access to electronic health records (EHRs).

METHODS: Patients diagnosed with ovarian cancer from January 2008 to November 2013 were retrospectively reviewed to determine the baseline referral rate for genetic counseling and testing completion in our practice. Implementation of a process change model combining provider training, patient education, enhanced electronic health record documentation and improved patient appointment scheduling strategies were implemented. We then prospectively collected data on all newly diagnosed ovarian cancer patients that had not already undergone genetic testing presenting from December 1, 2013 to November 30, 2016.

RESULTS: Genetic referral rates, genetic counseling and testing completion rates were markedly improved. Pre-implementation our genetic testing rate was 27% and post implementation our testing rate was 82% (p-value≤0.001).

CONCLUSIONS: Low cost interventions that target education of both providers and patients regarding the importance of genetic testing along with utilization of the EHR and streamlined patient appointment services can significantly increase rates of genetic testing completion.

Author List

Uyar D, Neary J, Monroe A, Nugent M, Simpson P, Geurts JL

Authors

Jennifer L. Geurts MS, CGC Director, Associate Professor in the Institute for Health and Humanity department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Denise S. Uyar MD Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Female
Genetic Counseling
Genetic Testing
Humans
Middle Aged
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms
Quality Improvement
Young Adult