Implementing the Provincial Post COVID-19 Rehabilitation Framework for Screening & Transitions in Alberta: A Pragmatic Evaluation

Post COVID-19 Syndrome affects about one in ten COVID-19 positive patients and is characterized by complex and chronic symptoms (e.g. fatigue, shortness of breath, limited activity tolerance, anxiety and cognitive problems) after the initial diagnosis. These can continue for months and can have a lasting, detrimental impact on patient health and quality of life. Rehabilitation can help relieve these symptoms. In March 2021, Alberta Health Services, a provincial health system, released the Provincial Post COVID-19 Rehabilitation Framework (PCRF) to support patients with Post COVID-19 Syndrome. It is based on international recommendations, consensus and co-design with patients, family, clinicians, administrators, and researchers. It includes care pathways, symptom screening and functional assessment tools, as well as education and self-management resources for patients, caregivers and clinicians, in order to address patient-specific post COVID-19 rehabilitation needs across the care continuum. A critical next step is to implement the PCRF across Alberta. This study aims to explore the impact of PCRF implementation on adult patients hospitalized with COVID-19 who transition home. We will study: (i) the impact of PCRF implementation on health system resource utilization; (ii) the patient and healthcare provider experiences before and after PCRF implementation; and (iii) the PCRF implementation strategy in terms of acceptability, adoption, feasibility and fidelity. The study will be done through surveys, focus groups and interviews conducted at many different time points before and after PCRF implementation so we can study its effects. In all analyses, we will look at how geographical location, sex, gender and ethnicity may affect PCRF implementation. The outcomes of this study are expected to support the spread and scale-up of the PCRF in Alberta, informing other health systems' approaches to support the diverse and complex symptoms of Post COVID-19 syndrome.