Improving hospital outcomes using an acute hospital rehabilitation intensive service (ARISE) for patients with COVID‐19

The initial surge of COVID-19 in 2020 placed an unprecedented strain on the hospital healthcare system [1]. In addition to critical respiratory complications, there was early recognition that COVID-19 could lead to significant hospitalacquired deficits with mobility, swallowing, and performance of activities of daily living [2]. In usual care, these impairments would require patients to receive rehabilitation in a post-acute care rehabilitation facility prior to returning home. However, post-acute care discharges were more challenging due to quarantine requirements, and many facilities could not accommodate isolation precautions. This led to growing concerns from clinical and operational leaders that these factors could significantly impact capacity management due to longer lengths of hospital stay and patient needs after discharge. To address these challenges, the Johns Hopkins Physical Medicine and Rehabilitation department developed a novel program deployed in the acute care setting. The acute hospital rehabilitation intensive service (ARISE) program was built on existing evidence supporting early rehabilitation for critically ill patients and concepts of acute inpatient rehabilitation that focused on early, individualized, intensive, and coordinated interdisciplinary rehabilitation to maximize functional recovery [3, 4]. Here, we sought to evaluate the impact of the ARISE program on the rate of discharge to home and length of stay in patients with COVID-19.