Dr Pim Kuipers1, Prof Michele Foster1, Anne Curtis2, Kiley Pershouse3, Dr Elissa Farrow3, Jennifer Finch3, Dr Belinda Gavaghan3
1The Hopkins Centre, Griffith University; 2Health Consumers Queensland; 3Queensland Health
Background: The initial preparation for and subsequent response to the COVID-19 pandemic resulted in major challenges across Queensland public health services and systems. In many health services, rehabilitation and sub-acute units were moved off campus, reduced, or dispersed, to increase acute hospital capacity. To explore the implications of these actions on rehabilitation and subacute services, we explored clinician and consumer experiences.
Methodology: The first phase comprised of an online survey of 123 rehabilitation professionals and subsequent online focus groups. This was followed by a series of qualitative case studies with clinicians across three rehabilitation services and in parallel, six “kitchen table discussions” with 34 rehabilitation patients and carers.
Results: From the perspective of clinicians, case studies highlighted significant challenges and disruption due to the prioritisation of acute over sub-acute care, the burden of managing higher throughput and more vulnerable patients with complex needs, and greatly increased pressure towards earlier discharge with limited community services. Together, these issues compounded concerns over more pressured and poorer quality services to patients.
Rehabilitation consumers described the negative impact that the COVID 19 response had on access to services in the hospital and continuity of care, and restrictions to family and carers visiting. They also emphasised the importance of communication, shared decision-making and choice.
Conclusion: This qualitative study describes the impact of the COVID-19 response on public rehabilitation services and proposes a critical role for rehabilitation as a mechanism to support patient care both in hospitals and within the community, particularly in times of crisis.
Belinda is a Director of Allied Health at the Allied Health Professions’ Office of Queensland, Clinical Excellence Queensland and an Adjunct Associate Professor at the Queensland University of Technology. She is a speech pathologist by background and is currently supporting work related to allied health workforce reform, service redesign and clinical education and training. Belinda has a PhD in public health and is a graduate of the NSW Public Health Training Program.