Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings

Abstract

An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.

The use of the environmental scan in health services delivery research: a scoping review protocol

“…Although environmental scans have been widely adopted in the healthcare sector to inform decision-making,12 31 37–59 there is no consensus on a definition to guide research and practice. This paper presents a protocol for a scoping review that will map the extent, range and nature of evidence examining the use or application of environmental scans within the health services delivery context.…”

“…Environmental scans have been used as an effective approach to information gathering for a range of specific purposes (table 1). These include reviewing the current state of services and programmes, evaluating community and patient needs, identifying service gaps, assessing professional education and training needs, supporting quality improvement initiatives, and informing programme and policy development 12 31 37–59. For instance, environmental scans have been used to assess remote symptom support training programmes for nurses in ambulatory oncology programmes56 and to describe paediatric navigation models across Canada 39…”

“…Despite the wide adoption of environmental scans within the healthcare sector,12 31 37–59 there is no consensus on a working definition or conceptual framework specific to health services delivery, and methodological guidance on the design and implementation of this approach to guide research and practice is lacking in the literature 12 29–31 45. Various terminologies have been used to describe the concept.…”

“…Various terminologies have been used to describe the concept. For example, environmental scans have been referred to as a ‘needs assessment tool’,12 ‘community health research tool’,30 ‘approach’,40 ‘mixed methods approach’,49 ‘methodological approach61 and ‘systematic survey’ 62…”

An Environmental Scan of Biopsychosocial and Clinical Variables in Cohort Studies of Cancer Survivors

“…Thus, we conducted an environmental scan of cancer survivor cohorts, to determine the scope and scale of information collected on demographic, biopsychosocial, and selected clinical variables from cancer survivors. Environmental scans utilize a variety of approaches (e.g., literature review, a targeted survey) to determine and interpret the scope of the pertinent literature on a particular health outcome (9)(10)(11)(12). This methodology is beneficial in the study of cancer survivors cohorts given the breadth of variables considered in cancer survivorship.…”