Precautions to prevent the spread of coronavirus infectious disease 2019 (COVID-19) were designed to limit contact between individuals and to control the spread of infectious organisms, yet these prevention measures present an obstacle for patients whose treatment relies on communal settings. Our acute-care hospital team sought to identify measures to prevent COVID-19 transmission while ensuring patients in the Behavioral Health unit and Inpatient Rehabilitation unit received optimal treatment.

Infection Prevention staff and unit-based clinicians collaborated to review patient care practices in each unit’s shared spaces, identify opportunities to prevent virus transmission, and develop algorithms to allow patients who were exposed or asymptomatically infected with COVID-19 to pursue treatment goals.

Changes were made in the Inpatient Behavioral Health Unit regarding patient masking expectations, group therapy sessions, shared equipment, and management of patients with COVID-19 exposure, symptoms, and infection. The inpatient Rehabilitation Unit developed new processes for the shared dining area, cleaning and disinfection of therapy equipment, use of shared shower rooms, and managing therapy needs for patients with COVID-19 exposure or infection. The new algorithms that were developed were successfully implemented to guide safe practice in these unique hospital settings. No COVID-19 transmission was observed in either unit.

Effective COVID-19 precautions can be implemented successfully while providing patients with treatment in communal environments. In our hospital’s inpatient behavioral health setting and in our inpatient rehabilitation environment, optimal results were achieved with close collaboration among infection prevention and operational staff focused on tailoring care to the specific needs of each unit’s patient population and providing tools adapted for these unique environments.