Tara Livingston1, Elle K Sullivan1, Grace Wilske1, Allison M Gustavson2. 1. Physical Medicine and Rehabilitation, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota USA. 2. Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota USA.
Abstract
OBJECTIVES: The novel coronavirus 2019 (COVID-19) has impacted acute rehabilitation delivery by challenging the reliance on in-person care and the standard practice of delivering separate physical and occupational therapy services. Healthcare systems are rapidly developing innovative models of care that provide essential acute rehabilitation services while mitigating viral spread. We present two case reports to illustrate how we used technology and COVID-19 specific decision-making frameworks to deliver acute rehabilitation. METHODS: We iteratively developed two decision-making models regarding care delivery and discharge planning in the context of the challenges to delivering care in a pandemic. We leveraged use of video communication systems installed in all COVID-19 rooms to reduce the number of in-room providers and frequency of contact. Two patients were admitted to the hospital with symptomatic COVID-19 (males, ages 65 and 40 years). RESULTS: With the use of video communication system and the decision-making frameworks for care delivery and discharge planning, we avoided 7 in-person sessions. Both patients demonstrated functional gains and were discharged home. CONCLUSION: The two case reports highlight the innovative use of a technology and COVID-19 specific decision-making processes to provide patient-centered care given the challenges to care delivery during the COVID-19 pandemic. IMPACT STATEMENT: The use of technology and decision-making models allows for delivery of safe acute rehabilitation care that minimizes contact, conserves personal protective equipment, and prepares for COVID-19 surges. The discussion points raised have applicability to patients without COVID-19 and other healthcare systems. Future research is needed to determine the effectiveness, costs, and downstream effects of our novel approach to acute rehabilitation for patients with COVID-19. Published by Oxford University Press on behalf of American Physical Therapy Association 2020.
OBJECTIVES: The novel coronavirus 2019 (COVID-19) has impacted acute rehabilitation delivery by challenging the reliance on in-person care and the standard practice of delivering separate physical and occupational therapy services. Healthcare systems are rapidly developing innovative models of care that provide essential acute rehabilitation services while mitigating viral spread. We present two case reports to illustrate how we used technology and COVID-19 specific decision-making frameworks to deliver acute rehabilitation. METHODS: We iteratively developed two decision-making models regarding care delivery and discharge planning in the context of the challenges to delivering care in a pandemic. We leveraged use of video communication systems installed in all COVID-19 rooms to reduce the number of in-room providers and frequency of contact. Two patients were admitted to the hospital with symptomatic COVID-19 (males, ages 65 and 40 years). RESULTS: With the use of video communication system and the decision-making frameworks for care delivery and discharge planning, we avoided 7 in-person sessions. Both patients demonstrated functional gains and were discharged home. CONCLUSION: The two case reports highlight the innovative use of a technology and COVID-19 specific decision-making processes to provide patient-centered care given the challenges to care delivery during the COVID-19 pandemic. IMPACT STATEMENT: The use of technology and decision-making models allows for delivery of safe acute rehabilitation care that minimizes contact, conserves personal protective equipment, and prepares for COVID-19 surges. The discussion points raised have applicability to patients without COVID-19 and other healthcare systems. Future research is needed to determine the effectiveness, costs, and downstream effects of our novel approach to acute rehabilitation for patients with COVID-19. Published by Oxford University Press on behalf of American Physical Therapy Association 2020.