Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems

• Published in: Gynecologic oncology Vol. 172; pp. 106 - 114
• Main Authors: Bednar, Erica M., Chen, Minxing, Walsh, Michael T., Eppolito, Amanda L., Klein, Molly H., Teed, Kelly, Hodge, Brittany, Hunter, Jordan, Chao, Han Gill, Davis, Dillon, Serchion, Wilshauna, Yobbi, Cara, Krukenberg, Rebekah, Jenkinson, Sandra B., Moore, Jennifer J., Garcia, Cassandra, Gonzalez, Fatimaeliza, Murray, Towanna, Nielsen, Linda D., Ho, Brenda, Haas, Megan, Greenzweig, Sarah B., Anderson, Abby, Johnson, Christina, Morman, Nichole A., Bowdish, Elizabeth, Wise, Emaline, Cooper, Julia N., Russ, Pauline Kefalas, Tondo-Steele, Katelyn, de Gracia, Buonarotti F., Levin, Brooke, Mattie, Kristin, Zarnawski, Kathryn, Kalasinski, Molly, Stone, Jennifer, O'Brien, Caitlin, Bream, Alexa, Kennedy, Aidan M., Paul, Rachel A., Bilbao, Michelle, Romero, Maureen, Carr, Rebecca L., Siettmann, Jennifer M., Vercruyssen, Anna K., Leon, Kaycee, Arun, Banu K., Grainger, Andrew V., Warshal, David P., Bowman, Erin, Goedde, Timothy A., Halaharvi, Deepa, Rath, Kellie, Grana, Generosa, Mina, Lida, Lu, Karen H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2023
• Subjects: Breast cancer; Female; Genetic Counseling; Genetic Testing; Hereditary cancer; Humans; Ovarian cancer; Ovarian Neoplasms - genetics; Ovarian Neoplasms - therapy; Quality Improvement; Triple Negative Breast Neoplasms - genetics; Quality improvement; Breast cancer; Genetic counseling; Genetic testing; Hereditary cancer; Ovarian cancer
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2023.03.016

A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A–E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC). QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, chi-squared/Fisher's exact test, and logistic regression. For patients with OC, improvement was observed in the rate of referral (from 70% to 79%), GC (from 44% to 61%), GT (from 54% to 62%) and decreased time from diagnosis to GC and GT. For patients with TNBC, increased rates of referral (from 90% to 92%), GC (from 68% to 72%) and GT (81% to 86%) were observed. Effective interventions streamlined GC scheduling and standardized referral processes. A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings. •A coordinated quality improvement initiative was completed in five community-based health system oncology care centers.•Referral, genetic counseling, and genetic testing improved for patients with ovarian and triple-negative breast cancer.•Average time to completion of genetic testing for patients with ovarian cancer significantly decreased at almost all sites.•The most effective quality improvement interventions standardized genetic counseling referral and delivery processes.