Abstract：
Genetic counselors (GCs) practice in critical care settings. Some GCs have full-time inpatient roles, while most GCs who see inpatients do so as needed or on a rotating schedule in addition to seeing patients in an outpatient setting. Few studies have tracked and compared the amount of time it takes GCs to perform tasks in the inpatient and outpatient settings. Genetic counselors were invited to participate in this study via the National Society of Genetic Counselors research listserv. Participants completed an online survey asking how their role is structured and what types of support are available to them while seeing inpatients. They also performed time tracking for 16 tasks known to be associated with inpatient and/or outpatient care via RedCap. These tasks include direct patient care, care coordination, and other tasks which encapsulate a new patient encounter from beginning to end. Forty-two inpatient encounters and 26 outpatient encounters were analyzed. The total average time spent on an inpatient consult (3 h and 38.5 min) was significantly higher than the time spent on an outpatient consult (2 h and 24.7 min; p < 0.05). Individually, genetic counselors spent significantly more time on the following tasks in an inpatient setting: direct follow-up encounters, multidisciplinary team communication, results disclosure encounters, results disclosure documentation, traveling, and waiting. Follow-up encounters, traveling, and waiting happen almost exclusively in inpatient settings. Short answer prompts regarding structure of GC role and available support revealed themes including lack of inpatient role structure, challenges with balancing between inpatient and outpatient tasks, and varied institutional support. These results promote further discussion about how to support GCs who see inpatients as these roles expand. Some suggestions include increased FTE/protected time and/or GCA support specific to the inpatient role.
摘要：
遗传咨询师(GC)在重症监护环境中的实践。一些GCs有全职住院的角色，而除了在门诊就诊外，大多数住院患者都会根据需要或按轮换时间表就诊。很少有研究跟踪和比较GCs在住院和门诊环境中执行任务所需的时间。遗传咨询师被邀请通过国家遗传咨询师协会研究listserv参与这项研究。参与者完成了一项在线调查，询问他们的角色是如何构建的，以及在看到住院患者时可以获得哪些类型的支持。他们还通过RedCap对已知与住院和/或门诊护理相关的16项任务进行了时间跟踪。这些任务包括直接病人护理，护理协调，以及其他从头到尾封装新患者遭遇的任务。分析了42例住院患者和26例门诊患者。住院咨询的总平均时间（3小时和38.5分钟）显着高于门诊咨询的时间（2小时和24.7分钟；p<0.05）。个别地,在住院环境中，遗传咨询师在以下任务上花费了更多的时间：直接随访，多学科团队沟通，结果披露遭遇，结果披露文件，旅行,和等待。后续相遇，旅行,等待几乎只发生在住院环境中。关于GC角色结构和可用支持的简短回答提示揭示的主题包括缺乏住院角色结构，住院和门诊任务之间平衡的挑战，和各种机构支持。这些结果促进了关于如何支持住院患者的GCs的进一步讨论。一些建议包括增加FTE/受保护的时间和/或针对住院患者角色的GCA支持。
