Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community
Manoj Sivan, Stephen Halpin, Lisa Hollingworth, Nicola Snook, Katherine Hickman, Ian J. Clifton
Academic Department of Rehabilitation Medicine, University of Leeds, D Floor, Martin Wing, Leeds General Infirmary, Leeds LS1 3EX, United Kingdom. E-mail: firstname.lastname@example.org, email@example.com
Objective: COVID-19 is a multisystem illness that has considerable long-term physical, psychological, cognitive, social and vocational sequelae in survivors. Given the scale of this burden and lockdown measures in most countries, there is a need for an integrated rehabilitation pathway using a tele-medicine approach to screen and manage these sequelae in a systematic and efficient way.
Methods: A multidisciplinary team of professionals in the UK developed a comprehensive pragmatic telephone screening tool, the COVID-19 Yorkshire Rehabilitation Screen (C19-YRS), and an integrated rehabilitation pathway, which spans the acute hospital trust, community trust and primary care service within the National Health Service (NHS) service model.
Results: The C19-YRS telephone screening tool, developed previously, was used to screen symptoms and grade their severity. Referral criteria thresholds were applied to the output of C19-YRS to inform the decision-making process in the rehabilitation pathway. A dedicated multidisciplinary COVID-19 rehabilitation team is the core troubleshooting forum for managing complex cases with needs spanning multiple domains of the health condition.
Conclusion: The authors recommend that health services dealing with the COVID-19 pandemic adopt a comprehensive telephone screening system and an integrated rehabilitation pathway to manage the large number of survivors in a timely and effective manner and to enable the provision of targeted interventions.
COVID-19 can cause considerable physical, mental, cognitive, social and vocational problems that persist for a long time in those who survive the illness. Given the scale of this burden and lockdown measures in most countries, there is a need for an efficient healthcare system for identifying individual’s needs and directing them to relevant rehabilitation services. Based on the nature and severity of symptom (s) on a previously developed telephone screening tool, the COVID-19 Yorkshire Rehabilitation Screen (C19-YRS), specific referral criteria for services have been developed in this study. Specialists needed for the rehabilitation services in the system are also described. The authors recommend that health services across the globe dealing with the pandemic adopt such a novel integrated rehabilitation system in order to manage the large number of COVID-19 survivors in an effective manner.
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