Managing outpatient oncology visits during COVID-19 pandemic: Addressing patients' concerns and precautionary measures.

35 Background: Implementation of precautionary measures in response to COVID-19 pandemic involve patients pre-visit screening of patients to detect any potential risk of infection and proper patient flow to the clinic and adherence to social distancing. Our study evaluates our center experience with the pre-visit screening calls and plans to optimize the process. Methods: As precautionary measure to COVID-19 pandemic, all patients scheduled for oncology outpatient visit were called by a nurse to screen them for any acute respiratory infection (ARI) and triage their visit into physical visit or virtual visit. Patients with high ARI score were directed for proper isolation and COVID-19 testing process and recommended to have virtual clinic visit with their oncologists. Those who have low ARI score and require in person clinic visit receive confirmation of appointment during the call with visit instructions. A tally of all responses and decision were maintained for process monitoring. Results: Between March 23, and June 13, 2020, 1,905 patients had pre-visit screening calls. Nurses could not reach 82 (4%) patients and 23 patients expired per family member report. Out of 1800 patients who responded to call, 1392 (77 %) had confirmed physical appointment, 179 (10%) switched to virtual appointments. Sixteen out of the 19 patients who have high ARI score have swab done. All patients were tracked to assure proper management of their symptoms and continuity of oncological care. A total of 229 (12.7%) patients refused to come due to COVID-19 concerns and all were rescheduled based on primary oncologists decision. A quality improvement project was initiated to understand the concerns of patients who refused to come and address them properly. Conclusions: Pre-visit screening call is a critical intervention, not just in assuring adherence to infection control measures, but in identifying patients concerns and addressing them. There is a need for implementation of updated patient education and awareness approach about the risk of COVID-19 infection and the importance of adherence to their cancer treatment plans.