Given the increasing demand for genetic counseling, implementation of innovative service delivery models (SDMs) has been proposed to improve access and increase the efficiency of genetic counseling services. This study investigated the key considerations in genetic counseling practices that impact the decision to implement innovative SDMs, as well as barriers and facilitators to implementation. A cross‐sectional, qualitative research design was employed, using focus groups. Genetic counselors (GCs) were recruited from respondents to an online survey about SDMs and by posting an invitation to the National Society of Genetic Counselors (NSGC) listserv. A total of 30 participants participated in either in‐person (n = 3) or online (n = 5) focus groups, facilitated by members of the Service Delivery Model subcommittee of the NSGC Access and Service Delivery Committee. Transcribed audio and written notes from the focus groups were coded, utilizing an inductive thematic analysis method. Five overarching themes that impact decisions to implement and use innovative SDMs were identified: (a) Patient volume and efficiency are key motivators in trying innovative SDMs; (b) the decision to change is facilitated by available resources; (c) the implementation of innovative SDMs is multidimensional and complex process; (d) there is concern about the impact on patient–provider relationships with the utilization of innovative SDMs; and (e) measuring outcomes of innovative SDM facilitates acquisition of additional resources and support. Approaches to innovative SDM selection and implementation vary by institution needs, resources, and population as demonstrated by the variety of approaches to similar barriers. Outcomes related to the implementation of innovative SDMs in genetic counseling practice should be measured to demonstrate the value of innovative genetic counseling SDMs, improvement of access to care, and to justify need for additional resources to support implementation of these models.

中文翻译：

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在遗传咨询中实施创新的服务提供模式：促进因素和障碍的定性分析

鉴于对遗传咨询的需求不断增加，已提议实施创新服务提供模式 (SDM) 以改善遗传咨询服务的可及性和效率。本研究调查了影响实施创新 SDM 决策的遗传咨询实践中的关键考虑因素，以及实施的障碍和促进因素。使用焦点小组，采用横断面、定性研究设计。遗传顾问 (GC) 是从受访者中招募的，参与一项关于 SDM 的在线调查，并通过向国家遗传顾问协会 (NSGC) 列表服务发出邀请。共有 30 名参与者参加了面对面 ( n  = 3) 或在线 ( n = 5) 焦点小组，由 NSGC 访问和服务交付委员会的服务交付模型小组委员会成员推动。使用归纳主题分析方法对焦点小组的转录音频和书面笔记进行编码。确定了影响实施和使用创新 SDM 决策的五个总体主题： (a) 患者数量和效率是尝试创新 SDM 的关键动力；(b) 可用资源促进做出改变的决定；(c) 创新 SDM 的实施是多维和复杂的过程；(d) 担心使用创新的 SDM 对患者-提供者关系的影响；(e) 衡量创新 SDM 的成果有助于获得额外的资源和支持。创新的 SDM 选择和实施方法因机构需求、资源和人口而异，正如解决类似障碍的各种方法所证明的那样。应衡量与在遗传咨询实践中实施创新 SDM 相关的结果，以证明创新遗传咨询 SDM 的价值、改善获得护理的机会，并证明需要额外资源来支持这些模型的实施。