Co-RIG Blog – Dr. Dee Mangin

Extended Primary Care During COVID: Care Models and Pathways for COVID and non COVID Illness

The COVID-19 Pandemic Response and Impact Grant (Co-RIG) Program: Phase II focuses on innovations and initiatives that prepare family physicians and their interprofessional teams to cope with challenges related to the pandemic and its long-term impact.

Dr. Dee Mangin, Department of Family Medicine, McMaster University, and her team continue their work from Co-RIG Phase I where they developed, piloted and implemented clinical pathways to support primary care teams managing moderate COVID and palliative COVID. In Phase II, the team looks to address 2 key needs:

  • To distinguish between primary care for mild-moderate COVID and post-COVID illness and to further ensure that those requiring more advanced care are detected and referred earlier, and those who do not need to be in the hospital are managed in the community.
  • To prevent the hospitalization and ensure the safe management of other acute conditions in the community that will in turn reduce burden on the health care system, prevent further spread of infection and improve quality of care by maintaining continuity and integration with the primary care team and family.

In partnership with McMaster University, Dr. Mangin and her team of health care practitioners look to expand the original COVID primary care model established in Phase I by:

  • Instituting a step-down care pathway from hospitals with early discharge once the patient is past the crisis. This process will be led by family physicians and make accommodations easy to set up at home.
  • Introducing a post hospital release pathway including a primary care pathway in partnership with occupational therapists for rehabilitation of persisting symptoms after acute COVID illness.
  • Developing and testing a pathway for care of acute COPD aimed to reduce the burden on the hospital system from other acute medical illness by supporting clinical care in the community by the primary care team.

The team hopes to reduce the need for hospital attendance and hospital stay, and the inherent morbidity and mental strain the patient can sustain long term. The ability to distinguish between patients that can be cared for at home and patients that need hospitalization will reduce strain on the primary health care system and individual health practitioners. Care at home will be provided to patients. This will ensure they feel comfortable and safe, while reducing external factors that can complicate their recovery.

Strong relationships continue to be built with home care, secondary care, and oxygen companies. Local homecare providers are offering services for rapid access through their Rapid Response teams and community paramedicine programs. Recovery can therefore happen organically, surrounded by loved ones at the patient’s own pace.

Resources are being added to the pathway as they are available.