Implementation and outcome evaluations of a multi-site improvement program in cancer genetics

Area of Science:

• Health Services Research
• Quality Improvement Science
• Cancer Genetics Implementation Science

Background:

• Disseminating clinical programs requires robust evaluation to understand successes and challenges.
• Cancer genetics services benefit from structured quality improvement (QI) initiatives.
• Virtual facilitation can support multi-site QI implementation.

Purpose of the Study:

• To evaluate the implementation and initial outcomes of a multi-site cancer genetics QI program.
• To assess program delivery, fidelity, and participant-reported outcomes.
• To identify implementation facilitators and barriers in diverse health systems.

Main Methods:

• A logic model guided the evaluation of program implementation and outcomes.
• Data collection included program documents and an Evaluation Survey of 21 participants.
• Descriptive statistics were used to analyze implementation data and participant feedback.

Main Results:

• The program was delivered with high fidelity, with all inputs, activities, and outputs meeting expectations.
• Participants reported significant improvements in QI knowledge, perceived importance and feasibility, and self-efficacy.
• Intermediate outcomes such as barrier identification and improved teamwork were achieved.

Conclusions:

• The genetic counselor-led, virtually facilitated cancer genetics QI program was successfully implemented across multiple sites.
• The program demonstrated high fidelity and led to significant improvements in short-term and intermediate outcomes.
• Future research should focus on long-term, patient-level outcomes.