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J. Friedman1, C. Dhesi-Bawa2, K. Kennedy2, S. Lee2, L. Hidalgo3
1University of St. Augustine for Health Sciences, San Marcos, United States, 2Sharp Healthcare, San Diego, United States, 3University of St. Augustine for Health Sciences, Miami, United States
Background: The prevalence of Post-Covid Conditions (PCC) is estimated to affect 10-35% of infected individuals, with upwards of 85% of previously hospitalized individuals reporting prolonged effects. Literature indicates deficiencies in communication between healthcare providers which can negatively affect patients. Due to limited interprofessional communication, there was a scarcity of individuals with PCC receiving comprehensive therapy treatment on an outpatient basis. The multi-system nature of PCC was an indication for interprofessional collaboration and the development of workflows facilitating access to care.
Purpose: This qualitative study investigates the Post-COVID-19 Rehabilitation Program (PCRP) at a California, USA multi-facility healthcare system. The PCRP was developed to provide individualized and comprehensive therapy services for adults suffering from persistent PCC while addressing logistical barriers within the existing healthcare delivery system.
Methods: An interprofessional team consisting of a physical therapist, respiratory therapist, exercise physiologist, and a pulmonologist collaborated to focus on outpatient management of PCC by implementing a Post-Covid 19 Rehabilitation Program.
The team created guidelines to direct referrals to various outpatient services from the hospital, associated pulmonary medical practice, and community. The team applied quality improvement and Lean principles to develop a Common Intake Form (CIF) for patients with PCC. This form contained demographics, identification of symptoms, previous treatments, pulmonary/cardiology test results, prior level of function, current goals, and identified barriers. The team provided 2 live educational sessions, digital resources, and protocols for departments regarding use of the CIF.
A Covid Liaison was trained to initiate the CIF and PCRP referral workflow with patients. One rehabilitation provider then evaluated the patient and finalized the CIF. That provider presented the evaluation and CIF results during Interprofessional COVID Rounds where determinations for additional referrals or services was made. Clinicians provided feedback multiple times regarding workflow, CIF, and general PCRP improvements.
The team created guidelines to direct referrals to various outpatient services from the hospital, associated pulmonary medical practice, and community. The team applied quality improvement and Lean principles to develop a Common Intake Form (CIF) for patients with PCC. This form contained demographics, identification of symptoms, previous treatments, pulmonary/cardiology test results, prior level of function, current goals, and identified barriers. The team provided 2 live educational sessions, digital resources, and protocols for departments regarding use of the CIF.
A Covid Liaison was trained to initiate the CIF and PCRP referral workflow with patients. One rehabilitation provider then evaluated the patient and finalized the CIF. That provider presented the evaluation and CIF results during Interprofessional COVID Rounds where determinations for additional referrals or services was made. Clinicians provided feedback multiple times regarding workflow, CIF, and general PCRP improvements.
Results: Conceptual content analysis of discussions with the health professionals revealed a need to better meet the needs of PCC patients. As the Common Intake Form (CIF) was developed, themes identified from the focus groups were: the CIF was too long, didn't include all relevant symptoms, the need for an open-ended portion, and redundancy of demographic information found in the chart. The feedback enabled the team to streamline the form and add a subjective portion cueing patients to “describe their Covid-19 journey.” The focus group suggested the CIF be converted to an online fillable format, creation of a Post-COVID Support Group, a Mindfulness & Self-Compassion course, and a Neuro-Cognitive Class for brain fog.
Conclusions: Creation of the CIF and PCRP was seen to have a positive impact by clinicians. Clinicians of all disciplines established connections and became active collaborators with a common goal focused on improving the functional outcomes of patients with PCC. Patients appear to be satisfied with the personalized approach towards their recovery and finding a community of peers.
Implications: The interprofessional rehabilitation approach is a practical model for patient-centered COVID-19 recovery; helping each patient navigate their unique PCC journey. Processes created during the implementation of the PCRP may set the groundwork for future interprofessional care approaches for Covid-19 and other diagnoses.
Funding acknowledgements: None
Keywords:
Covid-19
Interprofessional collaboration
Workflow development
Covid-19
Interprofessional collaboration
Workflow development
Topics:
COVID-19
Disability & rehabilitation
Community based rehabilitation
COVID-19
Disability & rehabilitation
Community based rehabilitation
Did this work require ethics approval? No
Reason: No patient data was used and administrators didn't feel ethics approval was necessary.
All authors, affiliations and abstracts have been published as submitted.
