Genomics is improving patient care in a wide range of medical specialties. Its use is increasing, thanks to pioneering clinicians and a growing number of funded tests.
But it can be difficult for hospitals to ensure good genomic care is provided across the board, or that every patient who needs genomics can get it. If healthcare executives and clinicians had a shared, hospital-wide view of genomic care, then they could ensure it was safe, high quality and cost-effective.
That’s why we’ve developed a world-first toolkit to help your hospital move forward with human and pathogen genomics.
- A toolkit for your hospital
- Key actions for hospitals
- What makes genomics challenging?
- Genomics and clinical governance frameworks
- Terminology in the toolkit
- How this toolkit was developed
A toolkit for your hospital
Genomics and Your Hospital is a toolkit designed to support hospitals in implementing high-quality genomic care.
It can help your hospital ensure that:
- good decisions can be made about new types of care
- the practice of genomic medicine is evidence-based, safe and effective
- the workforce is appropriately skilled and qualified
- patients and families are at the heart of the service
You will find seven key actions that provide a strong foundation for any hospital. Each action has an accompanying tool.
Watch: A/Prof Cate Kelly explains why every hospital needs a plan for genomics.
Key actions for hospitals
What makes genomics challenging for hospitals?
A number of factors can make genomics seem challenging to implement. These can include the perceived complexity of genomics, challenges common to any emerging medical practice, resource and prioritisation challenges faced by any health service.
Challenges specific to genomics
- Innovation and research occur in multiple specialities, often in small cohorts
- High-technical language that is not always understood beyond practising clinicians
- Families can also be ‘patients’ in genomic care
- Datasets are large, complex and highly personal
Challenges common to emerging practice
- Rapidly updating and emerging evidence
- Specialised workforce requirements and sometimes a lack of clarity about education and training requirements
Challenges common to health services
- Financial challenges across the health system
- Lack of ‘bandwidth’ for non-urgent activity
When hospital executives and clinicians get together to work through these challenges, it becomes much easier to make good decisions about genomics.
Genomics and clinical governance frameworks
Genomic care is not standalone. It should be reviewed in the context of your hospital’s existing clinical governance framework, capabilities and needs.
Due to the challenges explained above, existing clinical governance frameworks don’t necessarily provide hospitals with enough guidance to make good decisions about genomics. That’s why the Genomics and Your Hospital toolkit was developed.
The toolkit started out as self-assessment of readiness for genomics, mapped to the key domains of a clinical governance framework. Useability testing helped make it simpler and more relevant – by identifying a handful of key actions that can greatly uplift any hospital’s genomic capabilities.
The key actions in the toolkit reflect clinical governance domains established by Safer Care Victoria.
| Clinical Governance Domain (Safer Care Victoria Framework) | Genomics and Your Hospital key action |
|---|---|
| Leadership and culture | Form your genomics leadership group |
| Partnering with consumers | Involve consumers in genomic medicine services |
| Workforce | Check workforce skills and support |
| Risk management | Understand and mitigate risks |
| Clinical practice | Support and monitor quality and value |
Terminology in the toolkit
Throughout the toolkit we have used the term genomic care rather than genomic medicine. We use genomic medicine to refer to a genomic test and clinical use of that test. While critical, this does not fully reflect the end-to-end, multidisciplinary processes required to achieve holistic patient care.
Genomic care incorporates all elements of person-centred clinical practice that includes genomic testing, including:
- Identification of patients who may benefit
- Referral
- Testing
- Clinical use of the results (including for advanced therapeutics)
- Care
- Education of the patient and family
- Potential future re-analysis for health care
It recognises the social, psychological, and ethical impact of genetic information and reinforces why a wide range of healthcare providers is necessary to facilitate genomic literacy and patient support.
A glossary of other relevant terms can also be found here.
How this toolkit was developed
The Genomics and Your Hospital toolkit was developed by the Melbourne Genomics Health Alliance with ongoing co-design and input from clinicians, consumers and healthcare leaders.
A workshop in March 2023 identified several areas where hospitals could improve their planning: from risk mitigation to workforce credentialling, quality measurement and consumer involvement. Expert working groups were formed to develop resources on professional governance and quality of care, while a reference group of senior healthcare leaders guided the entire project.
The first iteration of the toolkit was tested for useability by five Victorian health services, from regional and metropolitan areas, and with different levels of genomic maturity. Their feedback made it simpler and more relevant – pinpointing seven key actions that can give any hospital a solid foundation in genomics.
The toolkit is now ready for use. But it remains a living resource that will evolve as genomics becomes a greater part of routine care.
© MGHA 2024. These materials were prepared by the Melbourne Genomics Health Alliance (MGHA) and are protected by copyright. We would like to acknowledge the expertise and knowledge of those who have contributed to the development of these materials. Reproduction or distribution of these materials without this notice is prohibited.