Remedy’s Plan for Return to Clinical Practice in Respect of 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 therapist at Remedy Massage Therapy commits to, and that all visiting patients must commit to, in order to resume massage therapy, chiropractic and acupuncture services. 

 

Coronavirus is transmitted via liquid droplets when a person coughs or sneezes. The virus can enter through these droplets through the eyes, nose or throat if you are in close contact. The virus is not known to be airborne (e.g. transmitted through the particles floating in the air) and it is not something that comes in through the skin.

 

It can be spread by touch if a person has used their hands to cover their mouth or nose when they cough. That’s why we recommend you cough or sneeze into your arm and wash your hands regularly.

 

Source: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/how-it-spreads

 

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

  • Required ongoing self-assessment for signs of Covid-19 related illness in both the patient and the therapist
  • 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 Covid-19: 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.
  • One day prior to their booked appointment, 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. The tool can be found here: https://bc.thrive.health/covid19/en
  • The therapist will contact the patient one day before their booked appointment to discuss using the self-assessment tool and the verify that it has been done.
  • The therapist will use the BC COVID-19 Self-Assessment tool daily and commits to canceling all appointments if symptoms appear.

 

Symptoms of Covid-19 are similar to other respiratory illnesses and seasonal allergies. An appointment must be cancelled immediately if either the patient or the therapist presents with even mild symptoms that may be signs of Covid-19 including:

  • Fever, Cough, Chills, Shortness of breath, Sore throat or pain with swallowing, Stuffy or runny nose, Loss of sense of smell, Headache,  Muscle aches, Fatigue, Loss of appetite

 

  • Covid-19 Symptoms may range from mild to severe. Patients are required to cancel appointments if they experience what they determine to be ‘just the sniffles,’ ‘seasonal allergies’ or ‘just feeling under the weather,’ on the day of their appointment.
     
  • 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 massage therapy and other treaments means that physical distancing is not possible in the treatment room.
  • In order for massage therapy/acupunture/chiropractic treatment to commence the therapist and patient must agree that the therapeutic benefit of massage therapy 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.
    • The patient and the therapist must both agree that the benefits of massage therapy outweigh the potential risks involved.
  • Patients who develop even mild illness or symptoms should cancel booked appointments, even without notice.
    • They will not be charged a late cancellation fee if they cancel due to illness.

 

Upon Arrival

  • The therapist will advise patients of his/her current Self-Assessment results upon their arrival at the clinic. Patients will be asked to share their own results.
  • Upon arrival patients must confirm that they have done a pre-screening and have no signs of Covid-19 as outlined here: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/symptoms
  • If the patient has a mask, they are asked to bring it with them and wear it when they arrive.
  • A mask will be provided to patients who do have one.
  • Patient must confirm that they have not travelled outside British Columbia within 14 days prior to their appointment.
  • 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

  • Patients must arrive unaccompanied unless a patient is a minor or requires assistance
  • Masks are mandatory for entering Remedy and while in the treatment room (unless they have medical conditions that prevents them from wearing a mask in treatment)
  • Maximum occupancy of reception area: 3 (with 2m physical distancing)
  • The therapist is the only other person who will be within the clinic space throughout the duration of the patient’s appointment.
  • The therapist and the patient will both maintain a space of 2 meters (6 feet) distance between each other in all clinic areas outside the treatment room.
  • Patients are not permitted to lounge in the clinic recaption area after the treatment.
  • Nothing remains in the clinic space that cannot be disinfected after each touch.
  • Patients are asked to arrive on time and not early or late for appointments

 

Within the Treatment Room

  • It is not possible to maintain physical distancing while in the treatment room
  • Masks are required when in supine position

 

Restroom for Patient Use

  • The restroom has been equipped with soap dispenser and paper towels and proper handwashing guidelines.
  • Soap and fresh paper towels for drying will be available at all times.

 

Hand Hygiene

Reception Area / Entry into Clinic Space

  • Immediately upon entering the clinic space the patient must either:
  • 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, or
  • Use the hand sanitizer dispenser inside the clinic

 

  • 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

 

  • Payment occurs in the reception area. Payments can be made prior to treatment to reduce congestion in reception area.
  • A wireless Point of Sale system with Tap is available for card use. Receipts will be emailed, not printed.
  • If there are multiple people taking payment at the reception desk - inform your client to stay in the treatment room until you notify them that is it clear to exit. 



In the Treatment Room

  • Patients will be permitted to open the door for themselves after the treatment to let themselves out of the treatment room.
  • Hand sanitizer is available within the treatment room; patients will be asked to wash or sanitize their hands before and after the treatment.
  • Chairs, massage tables, face pieces, 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 if they are in the clinic space outside of the treatment room for an extended amount of time.
  • 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 and disinfected
  • 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):
    •  Light switches, door knobs, POS machine, electronic devices, table surfaces, chairs, stools, window coverings, faucets, etc.
  • The treatment table, table levers, face cradle, lotion bottles will be immediately after each treatment.
  • All linens, including blankets and pillow cases are single use only and will be laundered using high heat, detergent and between each use.

 

Personal Protective Equipment

  • The therapist will wear a face mask at all times in the clinic.
  • Safety Glasses are also considered appropriate and will be worn by the therapist at the patient’s request.
  • Patients are required to wear a facemask if in the clinic outside of the treatment room for an extended period of time.
  • If patients have their own fabric facemask, they are requested to bring it. Masks will be available for purchase for $1.00

 

Professional Obligations - Liability Insurance

  • The therapist carries professional liability insurance through the Registered Massage Therapist Association of BC.

 

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.
  • The patient must agree to the release of this information in order to receive treatment.
  • All massage 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.

 

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 treatment involves some risk of Covid-19 transmission;
  • The therapist 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 RMT will document the patient’s consent in advance and at every treatment.

 

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