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GCs become established in a new position in 4 months, as indicated by decreases in documentation time

Poster presented at the 2020 National Society of Genetic Counselors Annual Conference

Authors: Colleen Caleshu, Kiley Johnson, Kaylene Ready, Cary Armstrong, Jill Davies

Background: With the rapid growth of the genetic counseling profession, organizations are often adding new genetic counselors (GCs) to their teams. Yet minimal data is available on the time required to onboard genetic counselors. Insights into how long it takes for new team members to get established can help inform hiring and training strategies.

Purpose: We sought to determine how long it takes genetic counselors to become stabilized in a new position, as indicated by change in documentation time (how long it takes to write clinic notes).

Methods: We performed a retrospective review of data from a national telehealth organization for consults performed from 4/15/2019 to 4/15/2020. We examined data for newly hired GCs who worked ≥20 hours/week and had been with our team for ≥8 months.

Results: The five GCs whose consults met inclusion criteria had a mean of 13.7 years of experience as a GC. They performed a total of 2537 consults in their first 9 months with our team, servicing a range of partners and specialties, with 44% of consults in a specialty that was new to the GC. Monthly mean documentation time: 1st month - 16.2 minutes (standard deviation (SD) 10.1), 2nd month - 15.1 minutes (SD 8.8), 3rd month - 11.5 minutes (SD 7.5), 4th month - 12.2 minutes (SD 7.7), 5th month - 10.8 minutes (SD 5.3), 6th month - 10.0 minutes (SD 6.1), 7th month - 9.4 minutes (SD 5.6), 8th month - 9.3 minutes (SD 6.1), 9th month - 10.3 minutes (SD 8.3). Mean documentation time decreased over time, leveling off around 4 months. Report times in months 1-4 were longer than in months 5-9 (13.2 vs 9.7 minutes, p<0.001, paired t-test of pooled documentation times). There was considerable variability, as indicated by the large standard deviations. This was due to both within-counselor and between-counselor variance. While standard deviations went down over time, both within and between genetic counselor variance remained even after documentation times stabilized. For example, mean documentation time for month 8 for individual genetic counselors ranged from 3.0 minutes (SD 1.9) to 13.1 minutes (SD 8.1), despite GCs servicing a similar mix of partners and specialties.

Conclusions: Experienced GCs get faster at documentation as they onboard to a new job, with documentation time leveling off around 4 months. Genetic counseling teams can use these data to set strategy and expectations for hiring and onboarding. The considerable variance seen within and between GCs indicates potential for process improvements to decrease longer documentation times.

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