Phase 3 Commmunicable Disease Prevention protocols

 

We will continue to wear masks throughout entire treatments, pre screen patients, observe physical distancing measures by staggering appointment times, reducing waiting room capacity, maintaining 2 meter distancing wherever possible, utilizing Personal protective equipment (PPE), and thorough disinfecting of treatment tables will occur before and after your visit.  Our policies are formed based on information and recommendations from our governing colleges, our insurers, the Provincial Health Organization,  The B.C Centre for Disease Control and patient and practitioner feedback. 

 

We have further protocols for clients in place to further decrease risk. We ask that you keep everyone’s safety in mind by adhering to the following:
  1. You will be directed to hand sanitize upon entering and exiting the clinic. A mask or face covering is required within the clinic. Should you forget one, we will have a limited supply available. We encourage you to wear laundered clothing, bring your own water, and use your own washroom facility before arriving. (Public washrooms will be available for necessary / emergency use).

  2. We recommend contactless payments. We will contact you ahead of time for pre-screening purposes, and to update your credit card information. You can also enter your own credit card into your online booking account. Receipts will be emailed

  3. If you are sick, have been traveling, or have come into direct contact with someone who has been ill you need to cancel your appointment. Appointments will be canceled at the time of visit if any patient exhibits signs of illness or fever.

  4. You will receive a mandatory pre-screen survey within a few hours of your appointment. Please note that if we do not receive this or hear from you, we may need to cancel your appointment

Harbour Health’s Plan for Return to Clinical Practice with Respect to Covid-19:

This plan was developed with the goal of reducing the risk of exposure to the virus that causes Covid-19 for both patients and the practitioner within our clinical setting.

 Here, we identify the actions that the therapists Harbour Health Integrated Therapies commit to, and that all visiting patients must commit to, in order to move forward in phase 3.

 

The overall aim of these protocols is to reduce potential communicable diesease transmission by:

·         Required ongoing self-assessment for signs of  illness in both the patient and the therapists

·         Reducing all physical, non-treatment related interactions amongst all people within the practice environment

·         Hand hygiene requirements

·         Avoiding face touching

·         Enhanced cleaning protocols

·         Appropriate use of personal protective equipment (PPE)

·         Meeting professional obligations, particularly related to informed consent and liability insurance

 

SELF-ASSESSMENT FOR SYMPTOMS OF COMMUNICABLE DISEASE: FOR PATIENTS & THERAPISTS

PRE-SCREENING / PRIOR TO ARRIVAL

·         Patients will be informed about their responsibilities at the time of booking. A notice will be placed on the website, and the online booking software will send them a copy of these protocols as part of a Covid-19 specific consent form they will be required to sign electronically, prior to arriving at their appointment.

·         Patients are required to cancel appointments if they experience any signs of illness on the day of their appointment. The 24 hour cancellation policy will not apply.

·         As a part of this consent form, patients must commit to understanding that while we’ve taken all possible measures to minimize risk of viral transmission, the nature of our treatments means that physical distancing is not possible in the treatment room.

·         In order for therapy treatment to commence the therapist and patient must agree that the therapeutic benefit of treatment outweighs any potential consequence of treatment, including the possibility of viral transmission.

·         Patients must confirm that they have not been in contact with anyone displaying illness, or signs and symptoms of Covid-19 within 14 days prior to their treatment.

·         Patients with higher risk profiles and/or weakened immune systems should consider alternatives for care and postpone treatment. 

o   The patient and the therapist must both agree that the benefits of treatment outweigh the potential risks involved.

·         Patients who develop even mild illness or symptoms should cancel booked appointments, even without notice.

o   They will not be charged a late cancellation fee if they cancel due to illness.

UPON ARRIVAL

·         Masks must be worn at all times within the clinic space. If the patient has a mask, they are asked to bring it with them and wear it when they arrive. If the patient does not have a mask, a single-use mask will be provided and they will be asked to wear it upon entering the clinic space.

·         The treatment will be cancelled immediately if the patient does not meet the pre-screening criteria upon physical presentation at the clinic.

 

PHYSICAL DISTANCING

RECEPTION AREA / ENTRY INTO CLINIC SPACE

·         Only 1 patient/person is permitted in the reception space at any given time. Patients must arrive unaccompanied unless an aid is necessary.

o   Patients are not permitted to lounge in the clinic reception area before or after the treatment.

·         water and cups have all been removed from the clinic reception area.  Tap water in a disposable cup is available on request but we encourage you to arrive hydrated or with your own water bottle.

·         Nothing remains in the clinic space that cannot be disinfected after each touch.

·         Appointment times are staggered to reduce the potential of patients crossing paths, and to allow for time in-between appointments for enhanced cleaning.

·         Patients are asked to arrive on time and not early or late for appointments.

·         Patients are required to wait in their vehicles or outside the clinic, until the therapist comes to the clinic door to call them in.

·         The clinic door will be opened for the patient by the therapist, or propped open If weather permits. The clinic door will be re-opened by the therapist at the end of the appointment for the patient to leave without touching the door knob.

WITHIN THE TREATMENT ROOM

·         It is not possible to maintain physical distancing while in the treatment room.

·         Patients will be asked to keep personal belongings in the treatment room to a minimum. 

 

RESTROOM FOR PATIENT USE

·      The restroom is sanitized daily and is available for patient use

·         Soap and fresh paper towels for drying will be available at all times.

·         A covered waste bin with a foot pedal is to be used to discard paper towel.  A second towel may be used to open door and be discarded in bin before exiting washroom.

 

HAND HYGIENE

RECEPTION AREA / ENTRY INTO CLINIC SPACE

·         Immediately upon entering the clinic space the patient must either:

o   Use the hand sanitizer dispenser that is fixed to the wall just inside the clinic door, or

o   Go directly to the handwashing sink without touching anything inside the clinic and wash their hands with soap and water for at least 20 seconds and then dry thoroughly

·         If hands are visibly soiled, the patient must opt to wash hands at the handwashing sink.

·         The therapist will wash hands thoroughly for at least 20 seconds between patients, before and after disinfecting spaces, before donning gloves and after taking gloves off, and before donning or doffing other PPE like facemasks or shields.

·         Hand washing protocols will be posted visibly in the reception area and at sinks.

·         Payment occurs in the reception area if there are no other therapists or patients in the space or in the treatment room if not. Cash will not be accepted at this time. A wireless Point of Sale system with Tap is available for card use. In the event that this does not work, and invoice may be emailed to the patient in order that they pay it online.  The POS machine will be sanitized between each patient.

·         Receipts will be emailed, not printed.

IN THE TREATMENT ROOM

·         The therapist will open the door to the treatment room and allow the patient to enter. The therapist will open/close the door before, during and after the treatment as required – reducing the need for the patient to touch the door.

o   Patients will be permitted to open the door for themselves after the treatment to let themselves out of the treatment room. 

o   Tissue is available inside the treatment room that the patient may use as a barrier when opening the door.

o   Hand sanitizer is available within the treatment room; patients will be asked to wash or sanitize their hands after the treatment.

o   The door and doorknobs will be disinfected between each patient.

 

AVOID FACE TOUCHING

·         The therapist will communicate with the patient that coronavirus can be transmitted by touch if droplets are on the hand when it touches the face, as it can transfer those infected droplets to the mouth, nose or eyes.

·         Tissue will be available throughout the clinic: in the reception area, treatment room and washroom in order that patients and the therapist may use tissue to address an itch and/or touch the face for any other reason.

·         The therapist will wear a mask at all times. 

·         Patients are required to wear face masks that cover both the nose and mouth at all times within the clinic space.

·         Interoral and external TMJ treatments will not be conducted at this time.

·         Musculature of the face will not be palpated or treated at this time.

 

ENHANCED CLEANING

·         Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room.

·         Visibly soiled surfaces will be cleaned followed by disinfection with a Canada Health Approved for use against Covid-19 disinfectant as listed here: https://www.canada.ca/en/health-canada/services/drugs-health-products/disinfectants/covid-19/list.html

·         Common areas will be cleaned and disinfected at least twice a day, including the restroom.

·         All high touch surfaces will be cleaned and disinfected between patients, regardless of appearances. High touch surfaces include (but are not limited to):

o   Light switches, door knobs, POS machine, electronic devices, table surfaces, chairs, stools, window coverings, faucets, etc.

o   The treatment table, table levers, face cradle, lotion bottles will be immediately after each treatment.

o   No hydrotherapy supplies or thermophores will be used.

o   A Cleaning and Disinfectant for Clinic Setting Poster will be on Display

·         All linens, including blankets and pillow cases are single use only and will be laundered using high heat, detergent and bleach between each use.

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PERSONAL PROTECTIVE EQUIPMENT

·         The therapist will wear a face mask at all times in the clinic.

o   If patients have their own fabric facemask, they are requested to bring it. If they do not have a fabric face mask, a single-use non-medcial mask will be provided to them at the time of their treatment.

 

PROFESSIONAL OBLIGATIONS

LIABILITY INSURANCE

·         The therapists carry professional liability insurance through their individual providers and the clinic carries professional liabitiy insurance through Shaw-Sabey as provided by the RMTBC

IN THE EVENT THAT A PATIENT ALLEGES THEY CAUGHT COVID-19 FROM THE THERAPIST

·         The therapist will immediately call public health at 8-1-1 to report the alleged transmission, providing both the name of the RMT and the name and contact details of the patient.

o   The patient must agree to the release of this information in order to receive treatment.

·         All therapy appointments will be cancelled and the Therapist will cease to provide services until Public Health has investigated and provided direction.

·         The therapist will immediately self-isolate until Public Health has investigated and provided direction.

IN THE EVENT THAT THE THERAPIST CATCHES COVID-19 OR DISPLAYS SYMPTOMS OF COVID-19

·         The therapist will immediately self-isolate.

·         The therapist will call public health at 8-1-1 to report the symptoms and request access to Covid-19 testing.

o   If testing is granted:

§  All therapy appointments will be cancelled and the Therapist will cease to provide services until test results are returned negative.

§  If testing proves positive the therapist will follow Public Health directives in informing patients treated over the previous 14 days about potential transmission.

o   If testing is not granted:

§  All therapy appointments will be cancelled and the Therapist will cease to provide services for a minimum of 14-days and until symptoms have ceased to present.

ASYMPTOMATIC SPREADERS

·         Asymptomatic transmission of the coronavirus is an unavoidable risk of practice until we’ve acquired herd immunity, there is an effective treatment or vaccine against Covid-19.

·         We have put into place protocols to help mitigate that risk as outlined in the preceding documentation.

 

INFORMED CONSENT

In the current environment of Covid-19 risk, informed consent requires that the patient be informed and understands that:

·         Any massage therapy, physiotherapy, acupuncture, chiropractic and naturopath treatment involves some risk of Covid-19 transmission;

·         The therapists are following protocol to help reduce or mitigate risk where possible, but that risk cannot be reduced to zero;

·         The patient consents to the treatment despite some risk;

·         And the therapist will document the patient’s consent in advance and at every treatment.