“BRCA质量改进推广计划”的成果：旨在改善五个医疗系统中患者接受癌症遗传学服务的举措。
Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems.
发表日期：2023 Mar 31
作者：
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
来源：
GYNECOLOGIC ONCOLOGY
摘要：
一项质量改进倡议（QII）在五家基于社区的医疗体系的肿瘤护理中心（站点A-E）进行。该QII旨在增加卵巢癌（OC）和三阴性乳腺癌（TNBC）患者的转诊、遗传咨询（GC）和生殖细胞系遗传基因检测（GT）。QII活动在几年内发生在不同的站点，均在2020年12月结束。回顾OC和TNBC患者的病历，比较QII前2年诊断的患者与QII期间诊断的患者的转诊、GC和GT率。采用描述性统计、双样本t检验、卡方/Fisher精确检验和Logistic回归分析结果。对于OC患者，观察到转诊率（从70％上升到79％）、GC率（从44％上升到61％）、GT率（从54％上升到62％）和诊断后到GC和GT时期的时间减少。对于TNBC患者，观察到转诊率增加（从90％上升到92％）、GC率增加（从68％上升到72％）和GT率增加（从81％上升到86％）。有效的干预措施简化了GC排班和标准化转诊流程。多年的QII提高了在五个不同的基于社区的肿瘤护理设置中患者的转诊和推荐遗传服务的使用。版权所有©2023 Elsevier Inc.
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.Copyright © 2023 Elsevier Inc. All rights reserved.