Multidisciplinary Quality Improvement Initiative


Advocacy

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In March 2021, the Academy launched a Multi-Disciplinary PASC Collaborative of experts to address Post-Acute Sequelae of SARS-CoV-2 infection (PASC or Long COVID) and the 3 to 10 million Americans it is affecting. AAPM&R understood the need for focused, meaningful and ongoing clinical exchange between the medical community to assess and implement appropriate clinical practice for treating and following all long-term COVID issues, not just those issues requiring PM&R intervention. The goal of the Collaborative was to foster engagement and share experiences to propel the health system towards defining standards of care for persons experiencing Long COVID-19/PASC.

The Multi-Disciplinary PASC Collaborative of experts developed:

  • clinical guidance to improve quality-of-care.
  • formal education and resources to improve experience-of-care and health equity.

The Collaborative did this by: 

  • Discussing and establishing best practices and protocols, including assessment and treatment principles;
  • Disseminating learnings and developing resources for the medical community, ensuring inclusion of primary care providers and those attempting to develop a PASC clinic;    
  • Engaging patient/caregiver partners to develop and disseminate patient resources; and,
  • Promote patient-centeredness and health equity.    

The collaborative was led by:

  • Benjamin Abramoff, MD, MS – University of Pennsylvania – Physical Medicine & Rehabilitation
  • Eric Herman, MD – Oregon Health & Science University – Chief Primary Care and Population Health Officer
  • Jason Maley, MD – Massachusetts General Hospital – Pulmonary & Critical Care

40+ Post COVID Clinics from across the country participated, with practitioners from multiple medical specialties and healthcare disciplines, as well as federal representation and patient organization representation.

The Collaborative’s guidance statements were released a rolling basis. Along with guidance statement development, the Collaborative focused on development of PASC clinical infrastructure guidance as well. As an estimated 80+ clinics were created, the Collaborative estimated that each could only handle 10-20 patients per week on average, compared to the millions of people experiencing symptoms. The need for infrastructure guidance, pediatric guidance development, and integrating health equity into each deliverable was critical to the collaborative's goals and supported the overall call to action. 

Published Guidance

Additional Resources

  • PASC Clinician Note Templates: Access the templates, to be used as a guide only.
  • Mental Health Guidance Statement: Access all of the tables, which include the treatment recommendation statements and pharmacologic agents used in depression, anxiety and PTSD.
  • Neurological Symptoms Guidance Statement: Access all of the tables, which include the initial treatment options, red flags, care guidance and more.
  • Pediatrics Guidance Statement: Access all of the tables, which include the methodology, recommendations, health equity considerations and more.
  • Autonomic Dysfunction Guidance Statement: Access all of the tables, which include the methodology, recommendations, health equity considerations and more.
  • Cardiovascular Complications Guidance Statement: Access all of the tables, which include the recommendations, health equity considerations/examples, rehabilitation approaches and more.  
  • Fatigue Guidance Statement: Access all of the tables, which include the methodology, recommendations, health equity considerations and more.
  • Breathing Discomfort Guidance Statement: Access all of the tables, which include the recommendations, health equity considerations/examples, rehabilitation approaches and more.  
  • Cognitive Symptoms Guidance Statement: Access all of the tables (also available in PowerPoint slides), which include the recommendations, screening tools, strategies, health equity considerations and more.