July 15, 2020
Methodist Hospital has treated over 500 positive COVID-19 patients since the pandemic’s inception. While medical experts uncover more data about COVID-19 infection and the respiratory disability that characterizes this disease, one of the most recognizable aspects identified in the treatment of non-critically ill COVID-19 patients is the significant delay in recovery times due to the nature of the disease and the treatment patterns itself.
As with any long-term hospitalization, isolation from sunlight, physical activity and socialization can significantly hinder a patient’s recovery. Human beings need timely exposure to light to regulate their circadian rhythm effectively; this entails the physical, mental, and behavioral changes that follow a daily cycle. Adequate exposure to light is critical for the health and well-being of patients as it reduces depression, decreases fatigue, and improves alertness. Another key component for recovery is mobility. Walking supports blood flow of oxygen throughout the body and helps maintain normal breathing functions while also stimulating the release of endorphins. Simple exercises during hospitalization has shown to have long-term impacts on a patients’ recovery as well as their quality of life.
Pulmonology experts at Methodist Hospital are piloting a new program, PATCH (Pulmonary Assessment and Therapy for COVID Health) for non-critical COVID-19 patients to assess much-needed daily physical and mental boost during a patient’s hospitalization after the critical phase of the illness is over but prior to discharge. With reinforced infection control measures, the program allows patients a way to engage with others in a safe environment by incorporating simple physical and social exercises. The program was approved by the Infectious Control division prior to initiation.
Misha Peter, MD, pulmonary, critical care and sleep medicine specialist at Methodist Hospital, designed and initiated the PATCH work place program. “COVID-19 has forced us, in some ways, to re-learn what we already knew. In our well-meaning attempts at controlling infectious spread, and to keep other patients and healthcare personnel safe, we neglected the simple tenets of recovery from any disease such as mobility, maintaining a regular sleep-wake rhythm and a positive mindset,” Dr. Peter commented. “This program was primarily designed to encourage that previously successful multi-disciplinary approach but in a controlled and safe manner. This minimizes the infectious risk to others while providing affected patients with the best tools for recovery and helps them return to a normal life.”
The program is executed daily on the 6 South telemetry COVID-19 unit, with a daily cap on the number of participants due to the constraints of staff and space. To ensure a safe environment and to maintain effective infectious prevention measures, both care teams and patients wear proper personal protective equipment (PPE). Patients are lead out of their negative pressurized rooms to an identified well-lit area in the ward for no less than 15 minutes per day. They undergo pre and post program vital checks to ensure stability. Depending on the patient’s condition, some simply benefit from exposure to environments other than their room while others are assisted with a 6-minute walking test in the hallway with standard cones utilized to mark milestones in meters. Time and distance progress are tracked on a common area scoreboard encouraging competition among each other.
Thomas Albauth, physical therapist at Methodist Hospital, has assisted with the PATCH program since it began. “We’re trying to get people to go home without oxygen as quickly and safely as possible,” he stated. “It’s so beneficial to bring patients out of solitary confinement to experience a sense of ‘normal life’ outside of their hospital room. We want our patients to push themselves safely and remain active on their road to recovery.”
Dr. Peter is very pleased with the initial response to the program, from both COVID-19 patients and the staff on the unit. She recalls patients requesting to be included in the program after their first experience because they feel firsthand the benefits of movement in a safe space, and they see the staff encouraging them to push forward.
“The staff feels united and motivated in providing the best care possible for these patients. I also personally feel this helps us [healthcare workers] to understand that we can still do our jobs well without fear as long as we maintain the recommended precautions. We are very hopeful that other local and national centers will move towards establishing similar programs during COVID-19 hospitalizations,” commented Peter.