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Innovative Care Delivery of Acute Rehabilitation for Patients With COVID-19: A Case Report
Author(s) -
Tara Livingston,
Elle K. Sullivan,
Grace C. Wilske,
Allison M. Gustavson
Publication year - 2020
Publication title -
physical therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 150
eISSN - 1538-6724
pISSN - 0031-9023
DOI - 10.1093/ptj/pzaa204
Subject(s) - rehabilitation , context (archaeology) , medical emergency , covid-19 , acute care , pandemic , health care , personal protective equipment , medicine , nursing , physical therapy , disease , paleontology , pathology , economic growth , infectious disease (medical specialty) , economics , biology
Objective 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. Health care systems are rapidly developing innovative models of care that provide essential acute rehabilitation services while mitigating viral spread. We present 2 case reports to illustrate how we used technology and COVID-19–specific decision-making frameworks to deliver acute rehabilitation. Methods We iteratively developed 2 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 a 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 dischargedhome. Conclusion The 2 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 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 health care 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.

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