Background: Baylor Scott and White McClinton Cancer Center (BSWMCC) is a comprehensive community cancer center located in Central Texas offering medical and radiation oncology services, plastic and reconstructive surgery, and lymphedema therapy, with approximately 275 patient encounters daily. Like much of the United States, BSWMCC and the state of Texas have been fighting COVID-19 since March 2020. Frequent policy changes, guidelines restricting visitors, and treatment delays caused by COVID-19 testing protocols became the “new normal” for oncology care during the pandemic. In mid-February 2021, winter storm Uri struck Texas, challenging the coping skills of patients and staff alike. Uri caused massive damage and created an acute crisis for BSWMCC and all of Waco, TX. At the onset of Uri, the roads to BSWMCC were almost impassable for 5 days. The Texas electric grid was near collapse, with rolling blackouts instituted throughout the state. Due to the record-low freezing temperatures, pipes at BSWMCC burst, causing millions of dollars in damage and a 12-week building closure. Consequences of Uri included: (1) delays in patient treatment, (2) BSWMCC services were unable to continue at the cancer center building, and (3) increased patient distress regarding treatment.
Objective: To provide a summary of the crisis response during the combined pandemic and winter storm, implemented by the Supportive Oncology (SO) team and cancer center administrators.
Methods: Distress ratings collected at each patient encounter were compared among pre–COVID-19, COVID-19, and winter storm periods. During and after Uri, BSWMCC developed an acute crisis response for oncology services. Administrators worked with interdisciplinary hospital leaders to relocate oncology services and disseminate information to cancer center teams. SO social workers and nurse navigators with electric power and computer access worked from home to notify patients by phone of BSWMCC closings and relocations and triaged medical and shelter emergencies for patients affected by blackouts. So team members worked to remove barriers to alternative treatment options.
Results: Distress screening comparisons between 2019 and 2020 to evaluate COVID-19 effect demonstrated the following: 2019 scores for 762 patient encounters were moderate distress (rating 5-7) 8%, and severe distress (rating 8-10) 3%; 2020 scores for 1151 encounters were moderate distress 3%, and severe distress 8%.
Distress score ratings regarding the winter storm were as follows: January 2021, moderate 11% and severe 4%; February 2021 (storm month), moderate 12% and severe 5%; March-April, moderate 12% to 14% and severe 4%; May 2021 (returned to original facility), moderate 16% and severe 3%.
Functionally, alternate clinic space was arranged so oncology services could resume during BSWMCC renovation. The 28-chair infusion center and lab moved to several large auditoriums at the campus’ main hospital. Radiation patients were treated by BSWMCC staff in the evening at a sister facility an hour away.
Conclusions: Maintaining cancer services during crisis provides continuity of care for patients and requires teamwork among interdisciplinary teams. Quantitative distress ratings and anecdotal statements demonstrated patient relief of severe stress upon returning to the cancer center. Local leadership became acutely aware of the significance of cancer center services. This acute crisis response for oncology services was recognized for its efficiency among local leaders.
