Nearly Half of Hospitalized COVID-19 Patients Discharged in Declining Shape

Nearly half of COVID-19 patients left the hospital with significant functional decline post-discharge, a new study from Michigan Medicine found. Of those survivors who suffered functional decline, 80% were referred for additional therapy after discharge. Nearly 20% of all patients declined to the point that they were no longer able to live independently, says the study, Functional Decline in Hospitalized Patients with COVID-19 in the Early Months of the Pandemic, published in PM&R.

“Rehabilitation needs were really common for these patients,” lead author Alecia K. Daunter, MD, a pediatric physiatrist at Michigan Medicine, said in a media release. “They survived, but these people left the hospital in worse physical condition than they started. If they needed outpatient therapy or are now walking with a cane, something happened that impacted their discharge plan.”

A new decision-making tool to help nurse leaders re-start family-presence policies that balance safety with a patient’s emotional need for family was released Tuesday.

The Family Presence Policy Decision-Making Toolkit for Nurse Leaders, a free resource, was developed by a stakeholder group consisting of nurses, healthcare executives, quality and safety experts, and patients and family caregivers convened by Planetree International, a not-for-profit organization that partners with healthcare organizations to create cultures of person-centered care.

Since the onset of the COVID-19 pandemic, healthcare systems have worked to manage the spread of the virus with restrictive policies that limit family members’ physical presence in care settings.

The policies removed family caregivers—or Care Partners—as essential members of their loved one’s care team from actively participating in supporting and caring for their loved ones.

California state health officials announced this week that they will extend a mask mandate through June 15, despite Centers for Disease Control and Prevention guidelines that lifted many of the restrictions for fully vaccinated people.

“Until June 15, when California plans to fully reopen the economy, California will keep our existing guidance around masks in place,” California Health and Human Services Secretary Mark Ghaly, MD, said in a media release.

“On June 15, California plans to implement the CDC’s guidelines around masking to allow fully vaccinated Californians to go without a mask in most indoor settings,” Ghaly said. “This four-week period will give Californians time to prepare for this change while we continue our relentless focus on delivering vaccines, particularly in underserved communities.”

It happens more than we’d like: Patients require transport from one area to another, be it from their room to an imaging lab or to the ICU, and somewhere along that trek—in a hallway, an elevator—they require emergency intervention. The patient is stabilized and completes their journey, but it’s a stressful situation for patient and provider alike.

A study on transporting intensive care patients found that out of 262 transports, 26% had an adverse event—many of which were serious, including oxygen desaturation or hemodynamic instability. How can clinicians work to avoid these situations? And how can organizations leverage the electronic medical record (EMR) to analyze how and when they happen?

Whether you are planning for a new healthcare facility or considering renovations or improvements to existing facilities, know that the next pandemic could present even greater physical environment challenges. The time to plan is now. For more than a year, maintenance teams, facility engineers, and contractors at hospitals across the country have stepped up to do yeoman’s work in meeting infection control needs as the COVID-19 public health emergency (PHE) swiftly overtook healthcare.

Now, as the PHE winds down, talk to your facilities and clinical staff about what new measures taken during the pandemic worked and what didn’t; consider what should be kept and what should be improved on for the next time.