Table 1.

Universal Genetic Testing Clinic Interventions

Intervention Category	Name of Intervention	Initiated	Location and (Duration)	Intervention Description	Metrics
I: Physician	Physician-coordinated genetic testing (PCGT)	2013	Main campus (for 5 months) and regional locations (ongoing)	Gyn Onc physician coordinated GT process independent of genetic counselor.	Number of patients who received GT coordinated by a physician
	Physician education	Ongoing	All locations (ongoing)	Attended national meetings and conferences discussing hereditary cancer. Gyn Onc genetic counselors provided education as needed.	Rates of GC/GT recommendation
	Tumor board/case review discussions	Ongoing	All locations (ongoing)	Discussed indications for GC/GT at weekly meeting, including verbal reminders by Gyn Onc department chair.	Rates of GC/GT recommendation
	Institution-wide research program	2013	All locations (ongoing)	Institution-wide research effort included support for various Gyn Onc projects, including the QI initiative.	Rates of GC/GT recommendation
II: Clinic	Integrated genetic counseling (IGC)	2006 and 2014	Main campus (ongoing)	Integrated GC in Gyn Onc (2006) Optimized GC schedule (2014) Standardized urgent appointment request process (2014)	Rate of GC completion and time between initial Gyn Onc visit and GC completion
	New-patient screening form	2013	Main campus (limited use by 2015 due to changes in new patient processes)	Form provided at initial Gyn Onc visit collected information regarding prior GT and family history of cancer. Completed form was scanned into the patient’s medical record.	Number of patients who completed the screening form
	Patient education document	2008	Main campus (limited use by 2015)	Patient education document described the purpose of Moon Shots programs, including GC/GT. Provided to the patient by advanced practice providers or other clinic staff.	Rates of GC/GT completion
III: Process	Assisted genetic counseling referral (AGCR)	2015	All locations (occurred 6/2015, 9/2015, 2/2016)	Electronic referral to GC drafted for patients with HGOC not previously offered GC/GT.	Number of referrals drafted, number of referrals signed within 1 month, and GC completion
	Clinic patient tracking	2012	All locations (through 2016)	Research data coordinator collected data from Gyn Onc clinic schedules and medical record to determine whether patients received GC/GT.	Not applicable: clinic patient tracking provided all data for all other metrics.
	Provider email notifications	2015	Main campus (occurred 3/2015, 4/2015, 5/2015, and 7/2016)	Research data coordinator and/or genetic counselor notified physician and care teams of upcoming patients not previously seen or referred for GC/GT.	Number of email notifications, referrals made within 1 month of email, and GC/GT completion

Bold text denotes the “key” interventions. Abbreviations: Gyn Onc, Gynecologic Oncology; GT, genetic testing; GC, genetic counseling; HGOC, high-grade, non-mucinous epithelial ovarian, fallopian tube, and primary peritoneal cancer