• Christine L Sheppard, Zara Szigeti, Robert Simpson, Jacqueline Minezes, Sander L Hitzig, Amanda Mayo, Lawrence R Robinson, Maria Lung, and Marina B Wasilewski.
• St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.
• J Eval Clin Pract. 2022 Dec 1; 28 (6): 971985971-985.

RationalePatients recovering from significant COVID-19 infections benefit from rehabilitation; however, aspects of rehabilitative care can be difficult to implement amidst COVID infection control measures.Aims And ObjectivesWe used the Consolidated Framework for Implementation Research (CFIR) to evaluate the rapid implementation of a COVID zone in an in-patient rehabilitation hospital at the onset of the first wave of the pandemic.MethodsSemistructured interviews were conducted with health care providers (n = 12) supporting the COVID zone, as well as with patients (n = 10) who were discharged from the COVID zone and their family caregivers (n = 5). The interviews explored the successes and challenges of working on the unit and the quality of care that was delivered to patients recovering from COVID.ResultsRapid implementation of the COVID zone was supported by champions at the middle-management level but challenged by a number of factors, including: conflicting expert opinions on best infection control practices (outer setting), limited flow of information from senior leaders to frontline staff (inner setting), lack of rehabilitation equipment and understanding of how to provide high quality rehabilitative care in this context (intervention characteristics), willingness and self-efficacy of staff working in the COVID zone (individual characteristics) and lack of time to reflect on and assess effectiveness (process).ConclusionsWhile there was an apparent need for rapid implementation of a COVID rehabilitation zone, senior leadership, middle management and frontline staff faced several challenges. Future evaluations should focus on how to adapt COVID rehabilitation services during fluctuating pandemic restrictions, and to account for rehabilitative needs of people recovering from significant COVID infections.© 2022 John Wiley & Sons Ltd.

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