This document provides guidance to acute care physicians and allied health professionals on referring people who are diagnosed with, or are recovering from COVID-19 to multidisciplinary rehabilitation assessment and management.
This document provides information
It outlines the criteria, method and communication expectations for referring people diagnosed with, or recovering from COVID-19 for assessment by rehabilitation medicine and multidisciplinary rehabilitation management.
Rehabilitation medicine can offer a wide range of services that have been shown to improve patient outcomes and decrease length of hospital stay.1
Multidisciplinary rehabilitation teams are led by rehabilitation medicine physicians who coordinate and prioritise a process of care by nurses, doctors and allied health therapists. They also coordinate medical liaison with other specialist clinical teams (e.g. respiratory, intensive care specialists, neurology, vascular, cardiac, etc.) as well as oversee ongoing management of comorbidities as required.
The settings in which these services are provided include:
The impact that timely referral can have to patient flow, health economics, patient outcomes and the release of acute and ICU beds should not be underestimated in the COVID-19 setting; and is well established in longitudinal studies in NSW.2
Multidisciplinary rehabilitation regularly and easily integrates with existing single therapy disciplines on acute wards, such as physiotherapists delivering early pulmonary or reconditioning rehabilitation. This coordinated care assists clinicians delivering single therapy care to complement their services with other disciplines of allied health (e.g. speech pathologists and occupational therapists), with care delivery coordinated by rehabilitation physicians according to the Principles to support rehabilitation care.3
There are a number of criteria to consider for referring COVID-19 patients for a multidisciplinary rehabilitation medicine assessment, these may include two or more of the following:
Rehabilitation medicine services include ongoing communication strategies with the referring acute teams and the preparation of virtual care teams and community services to continue care in the home for those with ongoing symptoms. Types of communication include:
Processes for referral for a rehabilitation medicine assessment will vary between and within LHDs but will include referrals to rehabilitation medicine team members made by phone, text, email, online and face to face.
In the event that your hospital does not have a rehabilitation medicine service on site, contact can be made to the ACI Rehabilitation Community of Practice secretariat Ms Louise Sellars on 0409 382 268, to identify the closest local services.
This document was developed by members of the Rehabilitation Community of Practice Executive group in consultation with directors of rehabilitation services, rehabilitation physicians and other rehabilitation clinicians working in both the public and private sectors. Document authors identified and reviewed relevant published research. Searches using Twitter between 1 August and 15 September 2020 were conducted using hashtags #covidrehab, #rehabilitation, #LongCovid and #rehab.
The rationale for the communications and referral documents comes from five key sources:
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Feedback on this document can be provided to
Members of the
Rehabilitation Community of Practice Executive group with consultation from COP members.
Community health and
Aged care / Aged health COPs reviewed draft versions of this document. Feedback received has been incorporated.
Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning, NSW Ministry of Health.
Louise Sellars, Rehabilitation Network Manager.
Acute care physicians, including those working in intensive care and respiratory wards, and allied health clinicians working in acute facilities.