Genetic Counselor-Genetics Clinic

				Overview:

The genetic counselor is a licensed health care professional with a specialized graduate degree and experience in the areas of medical genetics and counseling. Genetic counselors work as members of a health care team, to provide genetic risk assessment, counseling, information and support to individuals and families affected with birth defects or genetic disorders, as well as those who may be at risk for a variety of inherited conditions. Genetic counselors serve as patient advocates and refer individuals and families to appropriate support services. They also serve as educators and resources for trainees, other health care professionals and the general public. Genetic counselors may engage in research activities related to the field of medical genetics and genetic counseling. Laboratory genetic counselors assist clinicians with genetic test identification, ordering, and perform duties related to result interpretation. The genetic counselor demonstrates and supports the philosophy, mission, values, standards, policies and procedures of Nationwide Children's Hospital.

Responsibilities:

PRINCIPAL DUTIES AND RESPONSIBILITIES Clinical Genetics/General Duties

1. Assists staff in obtaining necessary medical records and information to facilitate referral triage and scheduling.

2. Obtains medical, psychosocial and family histories to help assess genetic risks and patient/family needs.

3. Assists in determining differential diagnosis, appropriate test selection, and plan of care with physicians.

4. Transmits information about genetic risks and mechanisms using counseling skills and visual aids if appropriate.

5. Discusses testing options available including advantages, disadvantages, risks, and limitations of the laboratory analyses.

6. Assists family in assimilation of the information presented, and in adjustment to its implications so that they can make appropriate decisions.

7. Makes appropriate referrals to community and health care resources when necessary in collaboration with physicians.

8. Interprets results in collaboration with physicians or other ordering providers. Contacts patients individually with laboratory results; answers any questions regarding their results and the implications..

9. Discusses family implications of testing. Provides follow-up support and additional consultation for families members as needed.

10. Summarizes findings for patient and referring physician with written or verbal communication, reviewed by the attending physician.

11. Tracks and manages for clinical and research purposes.

12. Provides training and supervision to genetic counseling students as appropriate and in line with level of experience.

13. Provides in-service education for outreach clinics, parent and community groups, students and other health care professionals, regarding genetics issues.

14. Provides in-service education for clinic staff, students, residents, and fellows.

15. Maintains and updates patient education materials and literature for use in the clinic.

16. Is familiar with and can discuss with faculty or patients/families relevant medical genetic literature. Clinical

Genetics/Specialty Clinics SPECIALTY CLINICS (CF, Muscular Dystrophy, Myelomeningocele, Williams syndrome, 22q deletion syndrome, Down syndrome, Complex Epilepsy Clinic, Craniofacial Clinic, THRIVE, PWS, NF, Cardiogenetics, Autism Center, Metabolic Clinic, SMA, Hematology/Oncology, etc.)

1. Facilitate development of Genetics involvement in new or existing NCH or affiliated specialty clinics

2. Includes all general genetics principle duties and responsibilities. Functions as the department liaison for genetic services as applicable.

3. Counsels families on issues of genetic diagnosis, recurrence risk, prenatal diagnosis, molecular and carrier testing and other relevant issues under supervision of clinic director.

4. Refers to appropriate clinical services based off clinical plan.

GENETIC COUNSELOR ONLY VISITS

1. Identifies patients appropriate for genetic counselor only appointments in collaboration with physician.

2. Facilitates scheduling of patients for appointments as needed, assists with collecting appropriate records prior to visit and reviews with collaborating physician as needed, completes independent consultation, completes documentation in electronic medical record, completes documentation for appropriate billing of appointment, creates and carries out plan of care in collaboration with physician.

3. Forwards clinic note and all other needed documentation to patient's primary care provider and all other applicable members of patient's healthcare team.

OUTREACH PATIENTS

1. Coordinates clinic schedule with local facility.

2. Obtains relevant records/charts for review.

3. Coordinates efficient acquisition and review of lab testing.

4. Travels to outreach clinics and assists physician as needed.

5. Writes counseling letter and/or provide disease-specific information to family when directed by MD.

6. Verifies follow-up appointments and specialty referrals are made.

INPATIENT CONSULTS

1. Is available by email, pager, and/or phone, at minimum, from 8:00am through 4:30pm Monday through Friday to acknowledge incoming consult requests. Communicates any gap in schedule availability with the attending physician and/or resident on-call as needed.

2. Reviews chart and obtains family and medical history on inpatient consults requiring genetic counselor involvement within 24 hours of notification.

3. Provides pre- or post-test counseling as indicated, reviews relevant lab results in conjunction with the attending physician and/or resident on call, and communicates results to the patient's family and healthcare team.

4. Responds to inquiries regarding genetic testing from other members of the patient's medical team and provides direction for the inpatient unit in selecting and ordering appropriate genetic testing.

5. Assists in maintaining a log of all consult patients regarding pending and resulted labs and follow-up recommendations.

6. Provides any appropriate follow-up communication to patients/families and providers as outlined in the Clinical Genetics/General Duties section.

Laboratory Genetic Counselor

1. Assists with process of sample accessioning by gathering additional information needed from submitting physicians and institutions. Gathers information regarding indications for study, medical and family history, etc. to provide optimal specimen handling and processing, and to allow accurate diagnosis and risk estimations.

2. Communicates test results to referring physicians, nurse practitioners, or other Genetic Counselors. Serves as a resource for information regarding genetic testing and identification of laboratories for follow-up/send-out testing. Maintains cost effectiveness, maximizing available resources for send-out testing.

3. Assists with searching the medical literature to provide further information in cases with abnormal cytogenetic or molecular genetic test results.

4. Assists with laboratory website development and maintenance. Assists in marketing activities in the IGM Clinical Laboratory through verbal and written methods.

5. Coordinates patient statistics for future use, utilizing computer programs suited to organize data.

6. Assists in training and teaching activities involving laboratory staff, students, residents, and fellows. Provides in-service education for laboratory staff, parent and community groups, students, and other health care professionals, regarding genetic issues.

7. Assists with the implementation of new laboratory testing.

Mentoring

1. Provides mentorship to GC-Is (if GC II), rotating GC students, medical students, fellows/residents Research Genetic Counselor 1. Identifies and recruits research subjects in accordance with IRB protocol and accrual goals. Keeps PI, co-PIs appraised of study progress. 2. Obtains and maintains IRB research training and certification. Helps develop and
			

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