Swabs by emergency responders (SWABBER): Enhancing care beyond the cancer center during the COVID-19 pandemic

97 Background: The COVID-19 pandemic caused sudden changes in healthcare delivery, and new policies were rapidly implemented to ensure safety for patients and staff. However, COVID-19 testing requirements presented a barrier for many patients. Outdoor testing in New York City became less feasible during colder months, and oncology patients have additional concerns, such as limited mobility and immunosuppression. To address these barriers, we created an in-home COVID-19 testing program through a partnership between Community Paramedicine and Oncology: SWABBER (SWABS by Emergency Responders). We evaluated patient use of and satisfaction with SWABBER. Methods: SWABBER began in September 2020 as an interdisciplinary initiative to offer in-home, asymptomatic COVID-19 PCR testing for patients on active treatment in an effort to provide more coordinated care and improve patient experience. Tests were performed prior to the first day of each treatment cycle at no cost to patients. Randomly selected patients completed a brief survey about their experiences with the program, with questions on a seven-point Likert scale. Sociodemographic data was collected from the EMR, and we used a chi-square test to identify differences in patient use of SWABBER by race. Results: From September 8, 2020–April 1, 2021, we saw 7,204 patients for infusion, of whom 993 (14%) participated in SWABBER. The cohort of all patients receiving treatment was 45% White, 19% Black, 6% Asian, 29% Other, and 1% Unknown race. The SWABBER cohort was 36% White, 21% Black, 12% Asian, 29% Other, and 1% Unknown race. There was a significant difference in patient race between these two groups (P < 0.00001), with more Black and Asian patients in SWABBER compared to all patients receiving treatment. A total of 406 (41%) SWABBER patients completed the patient experience survey. The mean scores for overall experience and likelihood of recommending the program were 6.9, with standard deviations of 0.56 and 0.44, respectively. Conclusions: SWABBER enabled us to deliver care directly to patients’ homes, mitigating COVID-19 exposure while promoting accessible care and providing an increased benefit for minority patients. Through SWABBER, we achieved near-perfect patient experience ratings, reduced the burden of testing, created a safer environment for patients and staff, and kept cancer care on track. Future work will evaluate ways to maintain elevated patient experience and continue striving for inclusive care beyond the pandemic.[Table: see text]