Surviving the COVID-19 Pandemic: Navigating the Recovery of Breast Imaging Services in a Safety-Net Hospital

Abstract Purpose: The purpose of this study was to determine the impact of COVID-19 on county safety-net breast imaging services and describe the steps taken to actively manage and mitigate delays. Methods: This was an IRB exempt retrospective review of our county-safety net Breast Imaging practice analyzed for 4 distinct time-periods: 1) “Shut-down period”: March 17, 2020 to May 17, 2020; 2) “Phased reopening”: May 18, 2020 to June 30, 2020; 3) “Ramp-up”: July 1, 2020 to September 30, 2020; and 4) “Current state”: October 1, 2020 to September 30, 2021. These time-periods were compared to identical time-periods 1 year prior. Results: Our safety-net practice sustained significant volume losses during the first 3 time-periods with a 99% reduction in screening mammography in the shut-down period. Cancers diagnosed decreased by 17% in 2020 (n=229) compared to 2019 (n=276). By implementing multiple initiatives that targeted improved access to care, including building community-hospital partnerships and engagement through outreach events, a community education roadshow and community health, we were able to recover and significantly exceed our pandemic screening volumes by 48.1% (27,279 vs 18,419) from October 1, 2020 to September 30, 2021 compared to the identical time-period 1-year prior, and exceed our pre-pandemic screening volume by 17.4% (27,279 vs 23,234) compared to the identical time-period 2-years prior. Conclusion: We present a roadmap for community outreach and optimized navigation, which helped maintain patient engagement and continue breast imaging services to low-income and minoritized women, as a guide for other safety-net practices.