It's been said that cancer does not discriminate. It does not matter your age, gender or social status: anyone can become a cancer patient. COVID-19 does not discriminate either. But if the two would intersect—if a cancer patient would also contract COVID-19—the outcome could be very serious. Like patients with other chronic diseases such as diabetes and heart disease, those with cancer are at a higher risk for developing severe complications with COVID. Additionally, cancer patients on chemotherapy can be immunocompromised, which means their white blood cell counts are low or not well-functioning. This makes it difficult to fight an infection like COVID-19.
But cancer treatments can't pause for COVID-19.
"Throughout the COVID-19 response, we've seen an average of about 85 patients every day in the Cancer Center, and some days have been as high as 110 patients" says Mary-Kate DePriest, MSN RN OCN, Director of Clinical Operations for Augusta Health's Center for Cancer and Blood Disorders. "This includes patients coming for chemotherapy and radiation treatments, as well as those coming for non-chemo infusions such as iron, platelets or antibiotics and some coming for clinic visits with physicians."
"There are obviously concerns when treating cancer patients during a pandemic like we're experiencing," adds DePriest, "and the answer has been safety, safety, safety! That's diligent screening, proper and constant social distancing, appropriate masking and good handwashing. Preventing our patients from getting COVID is very important, so we've adapted our processes. We're reducing their exposure and treating them efficiently while continuing to be sure they are satisfied with our services and care."
The waiting room has been eliminated. Instead, patients drive up to the Center's entrance, where they are greeted curbside by key members of the staff. The patient—along with everyone in the car—is asked screening questions about respiratory symptoms, fever, travel and exposure to anyone suspected or confirmed to have COVID-19. The patient is then checked-in to the appointment curbside. If all is ready, another staff member comes out to escort the patient directly into his or her appointment. Inside, staff asks the patient additional, more in-depth screening questions and takes the patient's temperature before beginning treatment. Most patients are masked; all staff is masked during treatments.
"We've had to make some additional changes to reduce exposure and maintain social distancing. For example, some of our treatment rooms have multiple chairs, and those chairs are too close together to use every chair. So we sometimes 'borrow' clinic space for infusion. We've also had to limit support persons to only one person for each patient, and only when that support person is required," explains DePriest. "People have been very understanding about all the changes. They respect and understand the situation. They recognize that the changes are for the health and safety of the patients and the staff."
The inside and outside staff use a secure Vocera system to communicate with each other and keep the schedule running smoothly. The changes have been very well-received by all.
"Patients have commented that they like this 'new service' very much," says DePriest. "It's been a very personal experience. They've realized everyone on the staff knows their name and who they are. They chat with the escort staff on the way to their appointment, and go right in to treatment without waiting. The staff is happier, too, because they believe we've got better control of the schedule and can more easily stay on time. The patient comes in when they are ready and we're ready to go. Wait times have actually been reduced with this new process."
Some of the changes—including the ability of the physicians to conduct some of the clinic visits via telehealth—are so well-received they may continue in the future.
"Our patients are very vulnerable to diseases like COVID-19 and they are also very valuable to us," says DePriest. "They need to continue their care during this time, so we need to continue to meet their needs and keep them safe from infection. To do that, our staff has been amazing and has adapted to so much so quickly, with a positive, professional attitude and good humor. They've focused on the safety of our patients, and it's worked very well."