Impact of Severe Winter Weather on Operations of a Radiation Oncology Department

Abstract

IntroductionDuring winter of 2022, Western New York faced two major storms with blizzard conditions and record-breaking snowfall. The severe weather resulted in power outages, and travel bans. This study investigates the impact of these conditions on patient adherence to radiotherapy. Combining data from a large academic center and its satellite clinic, this single-center study is shedding light on the challenges faced by cancer care facilities during severe weather and proposing suggestions to prevent and mitigate harm done by severe weather. MethodsIn this study, data was collected using the MOSAIQ Record and Verify system (v. 2.81) to generate deidentified reports of scheduled and treated patients. The treatment adherence rate was calculated by dividing the number of patients treated by the total number of patients scheduled. Data was specifically collected for patients undergoing treatment on linear accelerators at a primary academic center and a satellite facility. The study focused on working days from November 1, 2022, to March 31, 2023, excluding weekends and holidays (as treatments are not routinely scheduled). Severe weather days were identified using advisories from the National Weather Service and local institution, including specific periods in November, December, and January. ResultsIn the study, 15,010 scheduled treatment visits were recorded across the academic center and the satellite clinic. The mean daily treatment adherence rate was 91.7%. Severe weather conditions led to a significant reduction in adherence, with rates dropping to 77.8%. Adherence rates during non-severe weather days were notably higher at 93.9%. Statistical analysis confirmed the substantial impact of severe weather on adherence (p<0.001). Severe weather had a more pronounced impact on the satellite clinic during periods of severe weather with absolute reduction in adherence rates of 21.9% vs. 15% in primary hospital). Moreover, adherence rates at the satellite clinic vs. primary hospital site was lower even under standard operating conditions (92.2% vs 94.0%, p<0.001). ConclusionAs a part of operational planning, it is important to be aware how severe weather can impact treatment adherence. The study findings underscore the importance of proactive measures to ensure patient access to healthcare services during adverse weather events and highlight the broader significance of incorporating Social Determinants of Health (SDOH) considerations into contingency planning for maintaining treatment continuity.