A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England
A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England
复制标题
DOI：
10.1186/1472-6963-10-125
复制
发表时间：
2010-05-14
影响因子：
2.8
通讯作者：
Farndon, Peter A.
中科院分区：
文献类型：
--
作者：
Bennett, Catherine L.;Burke, Sarah E.;Farndon, Peter A.
背景资料：随着遗传学的进步与主流医疗保健的关系越来越密切，一个主要的挑战是确保这些进步适当地融入主流医疗服务。在2003年，英国卫生部宣布启动资金的可用性为10个“主流遗传学”试点服务，以开发模型，以实现这一点。方法：多种方法被用来探索飞行员的经验，将遗传学，这可能会通知在未来的新服务的发展。与项目工作人员，电子邮件调查问卷，访谈和试点最终reports.Results的专题分析进行了研讨会：七个主题有关的整合到主流医疗服务的遗传学被确定：规划服务，将遗传学;参与的遗传学部门;建立的作用，将遗传活动;确定和参与利益相关者;跨专业界限工作的挑战;与多个医疗保健组织合作;以及遗传条件的文化意识的重要性。试点人员发现，规划阶段通常包括需要提高对遗传条件和服务的认识，并且早期考虑诊所位置等组织问题至关重要。遗传学部门的正式参与是成功的关键;好处包括为新角色的工作人员提供临床和教育支持。通常职业道路之外的新角色的征聘和保留有时证明是困难的。专业工作实践的差异以及与多个医疗机构的合作也带来了挑战，例如与家庭合作的“遗传方法”，不兼容的记录系统以及卫生专业人员自主实践的不同方法。"实践要点"已整理成一个工具包，其中包括来自试点的资源，包括工作说明和临床工具。这些可以定制为重用其他service.Conclusions：医疗服务需要转化为患者的利益在遗传学的进步。在将遗传学纳入主流医疗服务时，考虑到这里提出的问题，将有助于确保新的服务发展建立在试点获得的经验基础上，为遗传病患者或有遗传病风险的患者提供高质量的服务。
Background: As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this.Methods: Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out.Results: Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services.Conclusions: Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.