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Consensus Recommendations for Maintaining Neurorehabilitation Quality During Healthcare Crises: A
Perrine Ferré1,2, Diana Zidarov2,3,4, Claude Vincent5
1School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Summary
The COVID-19 pandemic negatively impacted neurorehabilitation quality, reducing functional independence for COVID-positive patients. Recommendations focus on balancing infection control with rehabilitation needs during crises.
Area of Science:
- Neuroscience and Rehabilitation Medicine
- Public Health and Healthcare Management
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems, particularly neurorehabilitation services.
- Inpatient Rehabilitation Facilities (IRFs) experienced significant disruptions, necessitating an examination of crisis response and care quality.
- Understanding the pandemic's differential impact on patient outcomes and operational strategies is crucial for future preparedness.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the quality of neurorehabilitation care in IRFs.
- To compare outcomes for COVID-positive patients (infected pre-admission vs. during rehabilitation) with non-COVID patients.
- To develop evidence-based recommendations for optimizing neurorehabilitation during public health crises.
Main Methods:
- A mixed-methods approach combining quantitative medical record analysis (n=495) and qualitative stakeholder consultations (n=88).
- Multivariable analysis compared neurorehabilitation outcomes across pre-pandemic, non-COVID, COVID-positive prior admission, and COVID-positive during rehabilitation groups.
- Qualitative data from patients, staff, and managers informed consensus-based recommendations.
Main Results:
- COVID-positive patients exhibited reduced functional independence at discharge compared to non-COVID patients.
- Patients infected during rehabilitation experienced longer lengths of stay and higher readmission rates.
- Qualitative findings highlighted psychosocial, discharge planning, and resource management challenges, exacerbated by social isolation.
Conclusions:
- The timing of COVID-19 infection significantly influenced patient trajectories and resource utilization in neurorehabilitation.
- Effective crisis management requires balancing stringent infection control measures with the essential components of quality rehabilitation.
- Consensus-based recommendations emphasize environmental adaptation, family engagement, socialization, and flexible management for resilient neurorehabilitation services.
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