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Poster Abstracts

Implementation Considerations for Delivering Inpatient COVID Rehabilitation: A Qualitative Study

Authors:

Christine Sheppard ,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Robert Simpson,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada Toronto Rehabilitation Institute, University Health Network., CA
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Zara Szigeti,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Jacqueline Minezes,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Sander L. Hitzig,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Amanda Mayo,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Larry Robinson,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Maria Lung,

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Marina B. Wasilewski

Sunnybrook Research Institute, St. John’s Rehab Research Program, Canada, CA
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Abstract

Introduction: Patients recovering from a COVID-19 infection experience persistent and long-term impairments that negatively impact daily functioning and quality of life. Thus, many require in-patient rehabilitation to improve health outcomes and promote recovery. The provision of rehabilitative care during the pandemic was challenged due to COVID-19 infection control measures. Therefore, in-patient rehabilitation hospitals were required to implement innovative strategies to ensure patients recovering from COVID had access to safe and effective rehabilitative care.

Objectives: We assessed the rapid implementation of a COVID-19 zone in an in-patient rehabilitation hospital at the onset of the pandemic using the Consolidated Framework for Implementation Research (CFIR). Qualitative data were gathered via one-to-one interviews with health care providers (n=12) affiliated with the COVID-zone, as well as from patients (n=10) and family care partners (n=5) discharged from the COVID-zone between March and September 2020. A qualitative descriptive approach was used to elicit a rich description of the barriers and facilitators to implementing the in-patient rehabilitation COVID-zone in order to inform the development of policy and practice recommendations.

Key Findings: While stakeholders understood the need for a COVID-zone within the in-patient rehabilitation hospital, there were several challenges identified with implementation that spanned all five domains of the CFIR. As no other rehabilitation hospitals were accepting COVID-19 patients, stakeholders described immense peer pressure to implement a COVID-zone quickly; however, frontline staff described a lack of opportunity to participate in implementation decision-making and had concerns about the location of the COVID-zone and staff capacity. While senior leadership hoped that aligning staff to work on the COVID-zone would enhance competency providing care, frontline staff varied in how comfortable they were working on the COVID-zone. Extreme ambiguity, complex personal circumstances, lack of access to rehabilitative equipment, and limited contact with patient families all strained implementation and required frontline staff to think creatively to ensure patients had access to safe and effective rehabilitative care.

Conclusions: Our findings point to several recommendations to facilitate the implementation of rehabilitation for patients recovering from COVID, including eliminating the disconnect between operational decision-making and professional practice, identifying champions at the frontline, management, and senior leadership levels to ensure effective information sharing, and enhancing staff capacity to provide COVID care.

Implications: The application of the CFIR point to several barriers and facilitators that are relevant for other facilities planning and implementing rehabilitation strategies for patients recovering from COVID. 

How to Cite: Sheppard C, Simpson R, Szigeti Z, Minezes J, Hitzig SL, Mayo A, et al.. Implementation Considerations for Delivering Inpatient COVID Rehabilitation: A Qualitative Study. International Journal of Integrated Care. 2022;22(S3):300. DOI: http://doi.org/10.5334/ijic.ICIC22351
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Published on 04 Nov 2022.

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