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

Erica M. Bednar; Minxing Chen; Michael T. Walsh; Amanda L. Eppolito; Molly H. Klein; Kelly Teed; Brittany Hodge; Jordan Hunter; Han Gill Chao; Dillon Davis; Wilshauna Serchion; Cara Yobbi; Rebekah Krukenberg; Sandra B. Jenkinson; Jennifer J. Moore; Cassandra Garcia; Fatimaeliza Gonzalez; Towanna Murray; Linda D. Nielsen; Brenda Ho; Megan Haas; Sarah B. Greenzweig; Abby Anderson; Christina Johnson; Nichole A. Morman; Elizabeth Bowdish; Emaline Wise; Julia N. Cooper; Pauline Kefalas Russ; Katelyn Tondo-Steele; Buonarotti F. de Gracia; Brooke Levin; Kristin Mattie; Kathryn Zarnawski; Molly Kalasinski; Jennifer Stone; Caitlin O'Brien; Alexa Bream; Aidan M. Kennedy; Rachel A. Paul; Michelle Bilbao; Maureen Romero; Rebecca L. Carr; Jennifer M. Siettmann; Anna K. Vercruyssen; Kaycee Leon; Banu K. Arun; Andrew V. Grainger; David P. Warshal; Erin Bowman; Timothy A. Goedde; Deepa Halaharvi; Kellie Rath; Generosa Grana; Lida Mina; Karen H. Lu

doi:10.1016/j.ygyno.2023.03.016

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

Erica M. Bednar, Minxing Chen, Michael T. Walsh, Amanda L. Eppolito, Molly H. Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B. Jenkinson, Jennifer J. Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D. Nielsen, Brenda HoMegan Haas, Sarah B. Greenzweig, Abby Anderson, Christina Johnson, Nichole A. Morman, Elizabeth Bowdish, Emaline Wise, Julia N. Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F. de Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M. Kennedy, Rachel A. Paul, Michelle Bilbao, Maureen Romero, Rebecca L. Carr, Jennifer M. Siettmann, Anna K. Vercruyssen, Kaycee Leon, Banu K. Arun, Andrew V. Grainger, David P. Warshal, Erin Bowman, Timothy A. Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H. Lu

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: 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). Methods: 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. Results: 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. Conclusion: A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings.

Original language	English (US)
Pages (from-to)	106-114
Number of pages	9
Journal	Gynecologic oncology
Volume	172
DOIs	https://doi.org/10.1016/j.ygyno.2023.03.016
State	Published - May 2023

Keywords

Breast cancer
Genetic counseling
Genetic testing
Hereditary cancer
Ovarian cancer
Quality improvement

ASJC Scopus subject areas

Oncology
Obstetrics and Gynecology

MD Anderson CCSG core facilities

Biostatistics Resource Group

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10.1016/j.ygyno.2023.03.016

Cite this

Bednar, E. M., Chen, M., Walsh, M. T., Eppolito, A. L., Klein, M. H., Teed, K., Hodge, B., Hunter, J., Chao, H. G., Davis, D., Serchion, W., Yobbi, C., Krukenberg, R., Jenkinson, S. B., Moore, J. J., Garcia, C., Gonzalez, F., Murray, T., Nielsen, L. D., ... Lu, K. H. (2023). Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems. Gynecologic oncology, 172, 106-114. https://doi.org/10.1016/j.ygyno.2023.03.016

Bednar, EM, Chen, M, Walsh, MT, Eppolito, AL, Klein, MH, Teed, K, Hodge, B, Hunter, J, Chao, HG, Davis, D, Serchion, W, Yobbi, C, Krukenberg, R, Jenkinson, SB, Moore, JJ, Garcia, C, Gonzalez, F, Murray, T, Nielsen, LD, Ho, B, Haas, M, Greenzweig, SB, Anderson, A, Johnson, C, Morman, NA, Bowdish, E, Wise, E, Cooper, JN, Russ, PK, Tondo-Steele, K, de Gracia, BF, Levin, B, Mattie, K, Zarnawski, K, Kalasinski, M, Stone, J, O'Brien, C, Bream, A, Kennedy, AM, Paul, RA, Bilbao, M, Romero, M, Carr, RL, Siettmann, JM, Vercruyssen, AK, Leon, K, Arun, BK, Grainger, AV, Warshal, DP, Bowman, E, Goedde, TA, Halaharvi, D, Rath, K, Grana, G, Mina, L & Lu, KH 2023, 'Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems', Gynecologic oncology, vol. 172, pp. 106-114. https://doi.org/10.1016/j.ygyno.2023.03.016

@article{45c9b45a3bd84c5ca68846e540edd000,

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

abstract = "Objective: 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). Methods: 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. Results: 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. Conclusion: A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings.",

keywords = "Breast cancer, Genetic counseling, Genetic testing, Hereditary cancer, Ovarian cancer, Quality improvement",

author = "Bednar, {Erica M.} and Minxing Chen and Walsh, {Michael T.} and Eppolito, {Amanda L.} and Klein, {Molly H.} and Kelly Teed and Brittany Hodge and Jordan Hunter and Chao, {Han Gill} and Dillon Davis and Wilshauna Serchion and Cara Yobbi and Rebekah Krukenberg and Jenkinson, {Sandra B.} and Moore, {Jennifer J.} and Cassandra Garcia and Fatimaeliza Gonzalez and Towanna Murray and Nielsen, {Linda D.} and Brenda Ho and Megan Haas and Greenzweig, {Sarah B.} and Abby Anderson and Christina Johnson and Morman, {Nichole A.} and Elizabeth Bowdish and Emaline Wise and Cooper, {Julia N.} and Russ, {Pauline Kefalas} and Katelyn Tondo-Steele and {de Gracia}, {Buonarotti F.} and Brooke Levin and Kristin Mattie and Kathryn Zarnawski and Molly Kalasinski and Jennifer Stone and Caitlin O'Brien and Alexa Bream and Kennedy, {Aidan M.} and Paul, {Rachel A.} and Michelle Bilbao and Maureen Romero and Carr, {Rebecca L.} and Siettmann, {Jennifer M.} and Vercruyssen, {Anna K.} and Kaycee Leon and Arun, {Banu K.} and Grainger, {Andrew V.} and Warshal, {David P.} and Erin Bowman and Goedde, {Timothy A.} and Deepa Halaharvi and Kellie Rath and Generosa Grana and Lida Mina and Lu, {Karen H.}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = may,

doi = "10.1016/j.ygyno.2023.03.016",

language = "English (US)",

volume = "172",

pages = "106--114",

journal = "Gynecologic oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

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TY - JOUR

T1 - Outcomes of the "BRCA Quality Improvement Dissemination Program"

T2 - An initiative to improve patient receipt of cancer genetics services at five health systems

AU - Bednar, Erica M.

AU - Chen, Minxing

AU - Walsh, Michael T.

AU - Eppolito, Amanda L.

AU - Klein, Molly H.

AU - Teed, Kelly

AU - Hodge, Brittany

AU - Hunter, Jordan

AU - Chao, Han Gill

AU - Davis, Dillon

AU - Serchion, Wilshauna

AU - Yobbi, Cara

AU - Krukenberg, Rebekah

AU - Jenkinson, Sandra B.

AU - Moore, Jennifer J.

AU - Garcia, Cassandra

AU - Gonzalez, Fatimaeliza

AU - Murray, Towanna

AU - Nielsen, Linda D.

AU - Ho, Brenda

AU - Haas, Megan

AU - Greenzweig, Sarah B.

AU - Anderson, Abby

AU - Johnson, Christina

AU - Morman, Nichole A.

AU - Bowdish, Elizabeth

AU - Wise, Emaline

AU - Cooper, Julia N.

AU - Russ, Pauline Kefalas

AU - Tondo-Steele, Katelyn

AU - de Gracia, Buonarotti F.

AU - Levin, Brooke

AU - Mattie, Kristin

AU - Zarnawski, Kathryn

AU - Kalasinski, Molly

AU - Stone, Jennifer

AU - O'Brien, Caitlin

AU - Bream, Alexa

AU - Kennedy, Aidan M.

AU - Paul, Rachel A.

AU - Bilbao, Michelle

AU - Romero, Maureen

AU - Carr, Rebecca L.

AU - Siettmann, Jennifer M.

AU - Vercruyssen, Anna K.

AU - Leon, Kaycee

AU - Arun, Banu K.

AU - Grainger, Andrew V.

AU - Warshal, David P.

AU - Bowman, Erin

AU - Goedde, Timothy A.

AU - Halaharvi, Deepa

AU - Rath, Kellie

AU - Grana, Generosa

AU - Mina, Lida

AU - Lu, Karen H.

PY - 2023/5

Y1 - 2023/5

N2 - Objective: 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). Methods: 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. Results: 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. Conclusion: A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings.

AB - Objective: 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). Methods: 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. Results: 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. Conclusion: A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings.

KW - Breast cancer

KW - Genetic counseling

KW - Genetic testing

KW - Hereditary cancer

KW - Ovarian cancer

KW - Quality improvement

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U2 - 10.1016/j.ygyno.2023.03.016

DO - 10.1016/j.ygyno.2023.03.016

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C2 - 37004303

AN - SCOPUS:85151330826

SN - 0090-8258

VL - 172

SP - 106

EP - 114

JO - Gynecologic oncology

JF - Gynecologic oncology

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

MD Anderson CCSG core facilities

Access to Document

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