Patel Devanshi, Blouch Erica L, Rodgers-Fouché Linda H, Emmet Margaret M, Shannon Kristen M
Center for Cancer Risk Assessment, Mass General Cancer Center, Massachusetts General Hospital, 55 Fruit St. - YAW 10B, Boston, MA, 02114, USA.
J Genet Couns. 2018 Jun 19. doi: 10.1007/s10897-018-0270-4.
The current practice of cancer genetic counseling is undergoing widespread change and scrutiny. While there are clinical resources for genetic counselors (GCs) regarding the delivery of cancer genetic services, there is limited literature regarding effective management of a genetic counseling clinical program. We have developed administrative tools to manage a large team of GCs at a single academic medical center over a period of increasing demand for genetics services, with the initial aim of decreasing wait time for urgent genetic counseling visits. Here, we describe the three main elements of the clinical operations: Balancing patient volume between GCs, scheduling tracks for both routine and urgent appointments, and a team of triaging GCs to ensure appropriate patient referrals. For each of these elements, we describe how they have been modified over time and present data to support the utility of these strategies. The preliminary evidence offered here suggests that these tools allow for an equitable distribution of patient volume between team members, as well as the timely and accurate scheduling of urgent patients. As a result of the experiences presented here, other genetic counseling programs grappling with similar issues should be aware that it is possible to shift clinical operations to serve certain patient populations in a more timely fashion while keeping both providers and GC staff satisfied.
当前癌症遗传咨询的实践正在经历广泛的变革和审视。虽然有针对遗传咨询师（GCs）提供癌症遗传服务的临床资源，但关于遗传咨询临床项目有效管理的文献却很有限。在对遗传学服务需求不断增加的时期，我们开发了管理工具，以管理单一学术医疗中心的一大群遗传咨询师，最初目的是减少紧急遗传咨询就诊的等待时间。在此，我们描述临床运作的三个主要要素：在遗传咨询师之间平衡患者数量、常规和紧急预约的排班流程，以及一组负责分诊的遗传咨询师以确保患者得到适当转诊。对于这些要素中的每一个，我们描述了它们随时间的变化情况，并展示数据以支持这些策略的效用。此处提供的初步证据表明，这些工具能够在团队成员之间公平分配患者数量，以及及时、准确地安排紧急患者就诊。鉴于此处介绍的经验，其他面临类似问题的遗传咨询项目应意识到，有可能在让提供者和遗传咨询工作人员都满意的同时，及时调整临床运作以更好地服务特定患者群体。
