Where to begin?

It is critical that you establish a plan of action for your organization, by including the following items:

• Who is part of the planning or “Champion Team”
   
• What are the planning team members learning needs
   
• What are the current institutional assets (i.e., people, genetic specialists, funds, systems such as electronic health record documentation)
   
• Are there competing challenges within the organization that may interfere with progress
   
• What are the learning needs of those in your organization
   
• Is the organization/workforce “ready” to embrace this initiative.

Step 1: Identifying the “Champion Team”

Champions are those in your organization that have the respect of others to lead change. They often recognize the value of a new innovation and have the vision of what is needed to help others learn about, value, and adopt the innovation in their environment. Administrators and educators in a practice setting often assume this leadership role. However, others at the local unit level, and even interdisciplinary team members may help facilitate this process and can be a member of the “Champion Team”. Identify champions who have the experience and perceived level of influence within your organization that will enable them to successfully begin this change initiative. It is helpful if they are knowledgeable about genetics but not a requirement.

Reference: Andrews, V., Tonkin, E., Lancastle, D., Kirk, M. (2014). Identifying the characteristics of nurse opinion leaders to aid the integration of genetics in nursing practice. Journal of Advanced Nursing 70(11), 2598–2611 PMID: 24773467.

The passion and commitment of team members to make this process happen can accelerate this change process in your organization. It is important to establish the “Champion Team” early on so that an action plan and timeline can be determined.

There are some key things to consider as you begin identifying Champion Team members:

• Who are the key stakeholders for integrating new genomic competencies that currently exist within your organization?
   
• Who are those individuals with the background or knowledge of genetics and genomics that could be included?
   
• What type of expertise and decision making will be necessary to develop an implementation plan and strategy for your organization?
   
• What are the goals and objectives you are trying to achieve?
   
• What is the timeline to achieve your goals and objectives?
   
• Who will be the lead project manager and lead the initiative?
   

Step 2: Personal Assessment and Learning Needs of the Champion Team

Once the Team has been established, the next step is to have the Team complete a personal assessment of their own genetics and genomics learning needs. A sample assessment is included here. Those with identified learning needs will want to utilize resources and opportunities to close their knowledge gaps. Your organization may want to reach out to experts in your area to provide workshops, offer grand rounds and inservices, or provide consultative services. There are educational resources available to help you close these gaps.

Step 3: Institutional Assessment and Learning Needs

There are several facets of an organization that need to be assessed when beginning an initiative such as this.

First, the infrastructure:

• Type of organization (i.e., academic, community, pediatric)
   
• Types of patients seen and interventions provided (i.e., acute, surgical, medical)
   
• Diversity of your service area
   
  • Age
     
  • Ethnicity
     
  • Socio-economic status
     
  • Population served
     
• Scope of services ( i.e., inpatient, outpatient)
   
• Specialty services provided (i.e., mental health, cancer)
   
• Workforce to be included in initiative (i.e., nurses only, interprofessional)
   
• Current genomics in practice
   
• Existing genetic services and expertise
   

Second, the assessment of current organizational assets (fiscal and human)

• Communication pathways
   
• Economic Plan and Budget (read more about this on the Administrator pages –link)
   
• Existing policies that support genomics competency integration
   
• Continuing education infrastructure
   
• Existing educational initiatives
   
• Technology availability (i.e., IT infrastructure and access)
   
• Electronic healthcare record (EHR) infrastructure

Third, determine the scope for inclusion and exclusion criteria for this initiative (will this service be available for everyone? If not, which staff will be included?)

• Inpatient
   
• Outpatient
   
• Current use of genomic information or genomic services in the practice setting
   
• Desired or targeted of genomic information or genomic services in the practice setting
   
• Gap analysis : Once the project scope has been determined, assessment of staff learning needs to be able to attain desired goals should be conducted. There are several ways to accomplish this assessment including using the GENETICS AND GENOMICS IN NURSING PRACTICE SURVEY (GGNPS) survey and Instructions for the survey. Use of this instrument is allowed and supported by the survey developers. This survey can provide a baseline of the status of workforce knowledge and practice.
   
• Follow-up with survey respondents by focus groups can allow time to expand on specific questions raised by survey results about interest, learning needs, and plans for next steps. This process may also help make participants more aware of the initiative goals and objectives. You might also provide a snapshot of the organization’s survey results to let them know baseline findings.