Objective
The aim of the study was to present: (1) physiatric care delivery amid the SARS-CoV-2 pandemic, (2) challenges, (3) data from the first cohort of post–COVID-19 inpatient rehabilitation facility patients, and (4) lessons learned by a research consortium of New York and New Jersey rehabilitation institutions.
Design
For this clinical descriptive retrospective study, data were extracted from post–COVID-19 patient records treated at a research consortium of New York and New Jersey rehabilitation inpatient rehabilitation facilities (May 1–June 30, 2020) to characterize admission criteria, physical space, precautions, bed numbers, staffing, employee wellness, leadership, and family communication. For comparison, data from the Uniform Data System and eRehabData databases were analyzed. The research consortium of New York and New Jersey rehabilitation members discussed experiences and lessons learned.
Results
The COVID-19 patients (
N
= 320) were treated during the study period. Most patients were male, average age of 61.9 yrs, and 40.9% were White. The average acute care length of stay before inpatient rehabilitation facility admission was 24.5 days; mean length of stay at inpatient rehabilitation facilities was 15.2 days. The rehabilitation research consortium of New York and New Jersey rehabilitation institutions reported a greater proportion of COVID-19 patients discharged to home compared with prepandemic data. Some institutions reported higher changes in functional scores during rehabilitation admission, compared with prepandemic data.
Conclusions
The COVID-19 pandemic acutely affected patient care and overall institutional operations. The research consortium of New York and New Jersey rehabilitation institutions responded dynamically to bed expansions/contractions, staff deployment, and innovations that facilitated safe and effective patient care.
time (A), the time the secretary pages patient technician (B), the time the technician rooms a patient (C), the time the technician notifies a resident (D), the time the resident spent reviewing the chart (E), the time the resident sees a patient (F), the time the resident presents to attending (G), the time resident and attending review patient together (H), the time resident finishes documentation (I) and the time patient checks out (J). Setting: Teaching clinic at tertiary care hospital residency program. Participants: SCI patients seen over a five month period in 2013. Interventions: N/A Main Outcome Measures: Definition of workflow and measurement of turnaround time.Results or Clinical Course: A total of 68 patients were seen in the clinic. Of those, thirty six patients had 9 out of 12 data points collected. The remaining three were missing. The average turnaround time of these patients was 104 minutes with 22% percent arriving 10 minutes after their scheduled appointment time. The average number of minutes to complete Steps A/B: 4.5, B/C: 8.7, C/ D: 1.7, E: 10.8, J: 6.4 and F/G/H/I 19.3 minutes per step. Conclusions: 104 minutes per visit was deemed too long. Literature shows a direct impact between a patient's wait time and their satisfaction. From this exercise we learned that there are gaps in efficiency in the areas of rooming patients, reviewing charts and actual clinicians' time. Perhaps, teaching time is partly responsible for the latter.
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