Proposed models for genetic counseling: which quality indicators by donabedian's model are more feasible?

Abstract

Genetic counselling is a complex process that helps people to understand and adopt medical, psychological and genetic aspects of the disease and enable them to make an appropriate decision. In this framework, we revisited all the existing models for decision-making and suggested their use in the process of genetic counselling, which may lead to more equitable and more favourable outcomes. Also, Donabedian's (Structure-Process-Outcome) model for the development of key performance indicators was applied to assess the quality in the process of genetic counselling. Quality indicators at SPO model in the process of genetic counselling were proposed. The social, economic and humanistic outcomes have also been identified. All defined quality indicators together represent a framework for monitoring, evaluation and continuous improvement of the process of genetic counselling. Although the new medical services of genetic counselling tend to be developed as a powerful multidisciplinary field, the implementation of quality management model will certainly help the development of collaborative practice.

Genetsko savetovanje je složen proces koji pomaže ljudima da razumeju i prihvate medicinske, psihološke i genetske aspekte bolesti, kao i da donesu odgovarajuću odluku u vezi sa njima. U ovom radu, revidirani su svi postojeći modeli za donošenje odluka i predložena je njihova upotreba u procesu genetskog savetovanja, što može da dovede do pravičnijih i povoljnijih ishoda. Za procenu kvaliteta u procesu genetskog savetovanja primenjen je Donabedijanov model (Struktura–proces–ishod), za razvoj ključnih pokazatelja performansi. Predloženi su pokazatelji kvaliteta na „Struktura–proces–ishod” modelu u procesu genetskog savetovanja. Takođe, utvrđeni su socijalni, ekonomski i humanistički ishodi. Svi definisani indikatori kvaliteta zajedno predstavljaju okvir za praćenje, procenu i kontinuirano unapređenje procesa genetskog savetovanja. Iako se nova medicinska usluga genetskog savetovanja razvija, kao snažno multidisciplinarno polje, primena modela upravljanja kvalitetom sigurno će doprineti razvoju kolaborativne prakse.