CLINICAL PRACTICE PLAN REGARDING COVID-19:

Interim health and safety protocol and guidelines:

The following protocol and guidelines were developed with the goal of minimizing the risk of transmission of the virus causing COVID-19 within our clinic setting. We identify the actions that the practitioners and staff at Active Balance commit to do, and that all patients coming to the clinic must commit to. *Please note this protocol is considered “interim” as they will be modified as the climate in healthcare adjusts at any time.

The overall aim of these protocols and guidelines is to reduce potential coronavirus exposure and transmission by: increasing physical distancing (non-treatment related interactions) among people within the practice environment, enhanced cleaning protocols, ongoing self-assessment health screening for COVID-19 related illness, personal protective equipment (PPE) use, hand hygiene requirements, avoidance of face touching, and meeting the professional obligation relating to informed consent and liability insurance.

SELF-ASSESSMENT FOR SYMPTOMS OF COVID-19

Prior to arrival at the clinic & pre-screening

  • Patients will be informed about their responsibilities at the time of booking. Details will be placed on the website, and the online booking software
  • One day prior to their booked appointment (within 24 hours), the patient will be required to complete the online BC COVID-19 Symptom Self-Assessment tool and to stay home if they experience any symptoms of COVID-19.
    • Practitioners will use the BC COVID-19 Self-Assessment tool themselves, prior to every shift and commit to cancelling all appointments if symptoms appear.
    • Reception staff will be self-assessing daily and commit to staying home if they have any symptoms.
  • An appointment must be cancelled immediately if either the patient or practitioner presents with any symptoms (2 or more) that may be signs of COVID-19. This includes: Sore throat, runny nose/sneezing, nasal congestion, hoarse voice, difficulty swallowing, decrease or loss of sense of smell or taste, chills, unexplained/unusual headaches, unexplained fatigue/malaise, diarrhea, abdominal pain or nausea/vomiting
  • 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.
  • Healthcare Workers ONLY, please use the HCW Exposures Risk Assessment Tool. If you are considered HIGH RISK, we ask that you do not book any appointments at this time. Please follow the recommendations as stated in the Risk Assessment Tool.
  • Patients must confirm they have not travelled outside of BC within the last 14 days
  • The patient will be required to electronically sign a consent and liability waiver (COVID-19 questionnaire) prior to every appointment. As part of the consent form, patients must commit to understanding that while the practitioners have taken all possible measures to reduce the risk of viral transmission, the nature of ‘in-person’ treatments at Active Balance means physical distancing is not possible in the treatment room.
  • Patients who have higher risk profiles and/or weakened immune systems should consider alternative care and postpone treatment.
  • Patients who develop even mild illness or symptoms must cancel booked appointments, even without notice.
    • They will not be charged a late cancellation fee if they cancel due to illness.

UPON ARRIVING AT THE CLINIC

  • Face masks must be worn at all times while in the clinic
    • If a patient does not have a mask, a single-use mask will be provided upon entering the clinic (unless they are medically exempt).
  • Hand sanitation will be available in the reception area and visible immediately upon entry.
  • The patients will be asked to confirm their current results from the online BC COVID-19 Symptom self-assessment tool.
  • Patients must confirm that they have completed the online pre-screening and have no signs of COVID-19
  • If a patient has not completed the online pre-screening, they will be required to do so onsite before they receive a treatment from the practitioner.
  • If a patient does not meet the pre-screening criteria upon physical presentation at the clinic, the treatment will be cancelled immediately, and no cancellation fee will be charged.

PHYSICAL DISTANCING

Reception area/Clinic space entry:

  • Patients must arrive no more than 5 minutes before their appointment.
  • Pets are not allowed in the clinic at this time.
  • Outside of the treatment room, practitioners, patients, and clinic staff will maintain 6 ft distance apart.
  • Physical plexi-glass barriers have been erected in the front desk reception area to ensure there is no contact between reception staff and patients
  • Reception area chairs and benches have been placed 6 feet apart to comply with physical distancing guidelines
  • Rehab products (resistance bands, Metagenic Vitamins, massage balls, rollers) are stored away (but will be available for purchase).
  • All items that cannot be disinfected after touching have been removed in the clinic space. Eg. Toys, Tea offerings
  • Additional time is added before and after each treatment for enhanced cleaning protocols.

WITHIN TREATMENT ROOM

  • It is not possible to maintain physical distancing while in the treatment room.
  • Patients will be asked to keep personal belongings hung on the coat rack behind the door, or placed in a specific area that will be thoroughly cleaned between each patient.
    • Please do not bring any non-essential items with you at the time of your appointment.
  • Patients will be asked to remove all belongings from the clinic that they bring with them.
  • The practitioner will open the door to the treatment room and allow the patient to enter. The practitioner will open/close the door before, during and after the treatment as required – reducing the need for the patient to touch the door. Should the patient open or close the door, it will be disinfected immediately after treatment.
    • A hand sanitation agent is available within the treatment room
    • The treatment room will be cleaned and disinfected between each patient, including the treatments table and common surfaces.

HAND HYGIENE

Reception area/clinic space entry:

  • Hand sanitization is available upon entry
  • All practitioners will wash their hands and forearms thoroughly for at least 20 seconds between patients, before and after disinfecting spaces, and before donning or doffing PPE (face masks).
  • Hand washing protocols will be posted visibly
  • Active Balance offers contactless payment
    • POS (point of sale) system is still available – tap payments are highly recommended.
    • Receipts will be emailed when possible

AVOID FACE TOUCHING

  • Tissue will be available throughout the clinic: reception area, treatment room and washroom in order for patients, therapists, and clinic staff to use tissue to address an itch and/or touch the face for any other reason.
  • All practitioners and patients (except those who are exempt) are required to wear face masks.

CLEANING PROTOCOL

  • Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room.
  • Common areas will be thoroughly cleaned every 3 hours. Washrooms will be thoroughly cleaned after each use.
  • All high touch surfaces will be cleaned/disinfected between patients, regardless of appearances. This includes (but not limited to): light switches, chairs, doorknobs, POS machines, electronic devices, table surfaces, stools, faucets, treatment table, table levers, face cradle, lotion/oil bottles.
  • All linens, and pillowcases are single-use only and will be laundered.
  • Disinfectant cleaners are approved as per Canada’s hard-surface disinfectant and hand sanitizers list (COVID-19).

PERSONAL PROTECTIVE EQUIPMENT

  • The practitioner will wear a face mask at all times.
  • Hands will be washed for a minimum of 20 seconds prior to putting the face mask on/off.
  • Patients are required to wear a clean face mask:
    • If patients have their own fabric face mask, they are requested to clean it prior to use, and to come to the clinic wearing it.
    • If patients do not have a fabric face mask, a single-use non-medical mask will be provided at the time of their treatment (unless the patient is medically exempt).

Risk

Please be aware that even though our protocol and guidelines have been implemented to reduce the risk of spreading or becoming exposed to COVID-19, it DOES NOT GUARANTEE a 100% RISK-FREE environment. It is up to the client’s discretion and therefore their own assumption of risk and personal responsibility to decide if continuing with their treatment at this time is in their best interest.

Professional Obligations

Liability Insurance

  • All practitioners carry individual professional liability insurance.
  • Practitioners are following all the necessary health and safety guidelines outlined by their regulatory college, BC Centre for Disease Control (BCCDC), Provincial Health Office (PHO), and WorkSafeBC, and that they are taking all reasonable precautions to clean and disinfect the clinic and all the surfaces within the treatment room.
  • No guarantees have been made by the practitioner that the patient may not come in contact with COVID-19 at or during an appointment.

In the event that a patient tests positive for COVID-19 having an “in-person” appointment within the 14-days prior to onset of symptoms:

  • The patient will contact the practitioner and inform them of positive test results and possible transmission of the virus immediately.
  • The practitioner will immediately self-isolate.
  • The practitioner will call public health at 8-1-1 to report the possible transmission and act on the direction of Interior Health.

In the event that a practitioner displays symptoms of COVID-19:

  • The practitioner will immediately self-isolate.
  • The practitioner will call public health at 8-1-1 to report the symptoms and request for COVID-19 testing.
    • All ‘in-person’ appointments will be cancelled and the therapist will cease to provide services until test results are returned negative.
    • If testing returns positive, the therapist will follow Interior Public Health directions in informing patients about potential exposure.

In the event that the practitioner comes into close contact with someone showing signs of COVID-19 related symptoms or tests positive for COVID-19:

  • The practitioner will immediately self-isolate.
  • All ‘in-person’ appointments will be cancelled and the therapist will cease to provide services until they are cleared by a public health official from Interior Health to safely return to work.

Asymptomatic Spreaders:

  • Asymptomatic transmission of the coronavirus is an unavoidable risk of practice
  • We have put into place protocols to help reduce that risk as outlined in this documentation.
  • No guarantees have been made by the practitioner that the patient may not come in contact with COVID-19 at or during an appointment.

Informed Consent

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

  • Any ‘in-person’ treatments involve some risk of COVID-19 transmission;
  • The practitioner is 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
  • The practitioner will document the patient’s consent in advance and at every treatment.

Resources:

BC COVID-19 Self-Assessment Tool

BC Centre for Disease Control, Symptoms

BC Centre for Disease Control, Travel

BC Centre for Disease Control

Provincial Health Officer Update: May 15, 2020

WorkSafeBC

CANADA – List of Hard-Surfaces & Hand Sanitizers

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