When we partnered with Ambry to launch our High-Risk Women's Program (HRWP) at HCA Florida Ocala in 2023, I was excited about the potential to improve early cancer detection and even prevention in our mammography patients. The Ambry CARE Program® (CARE) provided the digital tools we needed to assess hereditary and breast cancer risk based on personal and family history, identify high-risk patients, and offer appropriate education, genetic testing, and follow-up care.
While Ambry provided implementation support and resources, we recognized an opportunity to further strengthen our program by investing in our staff's understanding and buy-in. This proactive approach to supplemental education ultimately proved to be instrumental to our program's success.
Identifying the Knowledge Gap
Leading up to the implementation of our new program launch, we realized our imaging center staff, the frontline ambassadors of this program, would benefit from additional education to strengthen their confidence in the importance of risk assessment as well as basic cancer genetics concepts.
We wanted them to understand more than workflows and what to say. We knew it was important that they truly understand the "why" behind the program. During our preparation discussions, we discovered that while staff had the basic process knowledge, they needed more confidence in articulating the benefits of the program and what testing could mean for patients and their family members.
We recognized that bolstering our team's knowledge and confidence would be essential to exceptional program implementation. After all, the more deeply our frontline staff understood and believed in the value of risk assessment and genetic testing, the more effectively they could communicate this to our patients.
Our Three-Pronged Educational Strategy
We decided to develop a supplemental, facility-specific education initiative to deepen staff understanding and strengthen our program buy-in. Our comprehensive approach included:
- In-person educational presentations delivered between February and June 2023 for HRWP employee stakeholders (mammography navigators, schedulers, registrars, radiology techs, and marketers)
- Educational content covering gaps in high-risk patient identification and the need for risk assessment that systematically identifies patients who qualify for genetic testing and/or increased screening, programmatic workflows, and impactful patient stories
- Post-training evaluation to measure improvement in knowledge and confidence before and after training
The education transformed our team's perspective on the program. What began as "just another process" became a mission they were invested in. They shifted from being transactional employees to advocates who understood how this program could fundamentally change - even save - patients' lives.
Measuring the Impact of Staff Education
To quantify the impact of our educational initiative, we surveyed employees using a 5-point scale that examined their knowledge of cancer risk assessment and genetic testing both before and after training. These findings formed the basis of our abstract poster presented at the Academy of Oncology Nurse & Patient Navigators (AONN) conference in 2024.
The results were remarkable:
- Employees strongly agreed that learning about genetic cancer risk illustrated why this program would benefit the community as a new tool in early cancer detection
- They strongly agreed that the new assessment and testing would positively impact early detection and improve patient outcomes
- Many acknowledged that they or someone they knew had a personal or family history of cancer but had never had genetic testing or risk assessment
- Most were previously unaware that genetic testing could be covered by insurance for qualified patients
- The education sparked their desire to discuss genetic risk assessment with healthcare providers for themselves or family members
But the most compelling evidence came after our program launch. By the end of our first month (June 2023), we achieved:
- 96% risk assessment completion rate (compared to 70% across the enterprise)
- 47% genetic testing completion rate for patients who qualified (compared to 22% across the enterprise)
These numbers validate what we discovered: when staff receive comprehensive education from leaders at their institution and truly understand and believe in a program, that program can reach new heights.
Best Practices for Staff Education and Engagement
Based on our experience, I recommend these best practices for organizations implementing a high-risk program:
- Provide multiple educational opportunities to capture all staff members and address all questions. One-and-done training isn't sufficient for complex programs that fundamentally change clinical workflows.
- Develop role-specific scripting for patient encounters. Each team member needs to understand exactly what information they should provide based on their role in the patient journey.
- Create clear workflows with assigned functions based on job role. Ambiguity leads to hesitation; clarity builds confidence.
- Provide context around relevant guidelines for cancer risk assessment and genetic testing. Staff don't need deep scientific knowledge—just enough to understand why the program matters and how the technology supports patient care.
- Leverage your lab or technology partner's expertise. A consultative lab or technology partner can provide valuable educational resources and support. Don't hesitate to ask them for assistance in staff training, educational materials, or implementation guidance.
- Make all staff stakeholders in program success. Help them see how their role contributes to the larger mission of early cancer detection and prevention.
The Impact: Technology Enhanced by Education
CARE was critical in transforming our approach to high-risk patient identification. Yet our experience demonstrated that CARE alone was not enough. By investing in supplemental staff education and creating buy-in for our own program, we created knowledgeable advocates who confidently communicated the program's value to patients.
As healthcare evolves toward more personalized, proactive approaches, organizations implementing high-risk programs should recognize the value of investing in comprehensive staff education. Taking ownership of implementation success means ensuring your team not only understands the process but believes in its importance.
Our experience at HCA Florida Ocala demonstrates that when staff truly understand the "why" behind what they're doing, they become champions for the program—and the ultimate beneficiaries are our patients, who receive potentially life-saving interventions through early detection and prevention.
