Using a pedigree-based questionnaire to improve efficiency in a general oncology genetics clinic.

Abstract

66 Background: Genetic counseling has two major components – education and medical history. Our Lyndon B Johnson (LBJ) General Oncology Genetics Clinic includes a diverse patient (pt) group. The majority of pts do not speak English, requiring medical translation, which lengthens encounters. To improve efficiency, a pre-visit genetics questionnaire (GQ) was created to gather pt and family history. Methods: The GQ includes: breast-obstetric history, urologic history, colon history, dermatology, maternal and paternal family history. Between November 2, 2017 and May 10, 2018 pts were contacted before their encounter. The GQ was given to pts, who were encouraged to complete it in advance, return electronically, or bring to the visit. Encounter duration for pts was calculated based on their check in and check out time documented in Epic. A partially completed GQ is defined as leaving a major section blank, like paternal or maternal history. Results: 92 pts were seen in the LBJ Oncology Genetics Clinic. The overall compliance rate for a completed GQ was 37% (Table 1). 51% of the pts were non-English speaking. For pts who completed the GQ, the mean overall cycle time is 55 minutes, which is reduced on average 33.0% compared to those who did not complete the GQ. Encounter duration in minutes, and compliance rate. Conclusions: We demonstrate that using a pedigree-based GQ in an Oncology Genetics Clinic is feasible with non-English speaking pts and can reduce clinic cycle times up to 33%. The greatest reduction in cycle time occurred when a completed GQ was emailed to the clinic. Interestingly, non-English speaking patients had a shorter cycle time compared to English speaking patients, which could be explained by an approximately twice as high compliance rate in the non-English speaking patients, further supporting the association between GQ completion and cycle time reduction. To improve cycle time further, increasing overall compliance rate from 37% provides a future direction.[Table: see text]