402 - Implementation and impact of dedicated inpatient genetic counselors in a Children’s Hospital

Poster Number: 402
Publication Number: 402.436

Megan Sikes, Seattle Children's, Seattle, WA, United States; Abbey Scott, Seattle Children's, Seattle, WA, United States; Tara L. Wenger, University of Washington Division of Genetic Medicine, Seattle, WA, United States

Background: While the role of genetic counselors (GCs) in outpatient clinics is well established, there is significant variability in the presence and role of GCs in the inpatient setting. With the growing use of rapid genomic testing, the need for inpatient genetic counseling services increases. Limited data are currently available on the effects of dedicated inpatient genetic counseling services on inpatient care, provider satisfaction, and billing.

Objective: To assess service billing practices and provider satisfaction of the genetics inpatient consultation service prior to and following the expansion of dedicated inpatient genetic counseling from 0.4 full-time equivalent (FTE) to 2.0 FTE.

Design/Methods: Consult billing data was gathered in the 18 months prior to and following the addition of two dedicated inpatient GCs. Questionnaires were sent to all pediatric faculty with inpatient attending privileges, as well as all clinical geneticists with inpatient responsibilities at Seattle Children’s Hospital to assess their satisfaction with the genetics consultation service in June 2019. A follow-up questionnaire was administered 18 months following the expansion of inpatient GC services to assess provider experience and satisfaction.

Results: Most respondents identified the need for increased inpatient GC access as the highest priority for improvement when initially surveyed. The follow-up questionnaire showed that all geneticists surveyed indicated that the FTE increase had “greatly improved” their experience as a consulting physician. Moreover, attending physicians who request genetics consults reported an increase in overall satisfaction with the genetics consult service over the same time period. Inpatient billing data showed that the relative value units generated by the inpatient genetics physicians more than doubled following the GC FTE increase.Conclusion(s): Adding dedicated inpatient GCs to the genetics consult service is supported by hospitalists and geneticists alike. This increase in inpatient GC FTE allowed for multiple improvements to the service, including better continuity of care, case tracking, timely return of results, improved documentation, and the creation of new collaborative educational conferences. The increase of inpatient GC FTE was also associated with an increase in genetics physician inpatient billing. Our data suggest the addition of dedicated inpatient genetic counseling may positively impact the care of hospitalized children in the era of increasingly complex and rapid genomic testing.