Protecting high-risk oncology patients during the pandemic of COVID-19 by creating an outpatient cancer clinic for febrile neutropenia (California clinic).

• DOI: 10.1200/jco.2020.38.29_suppl.191
• Publication Date: 2020-10-08T13:35:56Z
• Authors: Manidhar Reddy Le...; Mohammad Abedi; Tammy Clarke; Bahar Moftakhar; Arpan Patel
• Keywords: Outpatient clinic; Case fatality rate; Pandemic

191 Background: Delivering care for vulnerable cancer patients during a pandemic is challenging given the competing risks of death from versus high case fatality rates SARS-COV-2 (CV-19). Data currently available suggests total rate close to 30%-50% with CV-19 in active malignancy patients. In addition adapting guidelines national organizations reduce social footprint order minimize risk exposure CV-19, our center implemented an isolated clinic personal protective equipment (PPE) and direct access rule out floor (if admission warranted) manage those febrile neutropenia (FN) who otherwise would have been triaged emergency room (ED). Methods: We outpatient extended hour PPE, blood work, intravenous antibiotics fluids FN as pilot project mid-April expected duration aim decrease ED admissions by 50%. used Multinational Association Support Care Cancer (MASCC) validated tool assist inpatient management these All were screened via polymerase chain reaction nasal swab identify high-risk population. Our PDSA (Plan Do Study Act) cycles 2-week sessions constant re-education multiple providers. Results: Prior databases show approximate 15 20 hematology oncology per month are business hours. Since implementation last 45 days, we 8 patients, which 2 discharged home oral on isolation until testing returned, 6 directly admitted avoiding ED. overall patient numbers low peak expect see increasing number utilizing over next few months. Conclusions: Implementing California has thus far successfully decreased highest-risk FN, hopes decreasing their possible well unnecessary clinical personnel. [Table: text]