Hello dear valued patients,
We are so excited to be able to see you and be part of your healthcare again!
Navigating this virus and reopening paramedical healthcare services is something that will require a calculated process, and you may notice that things are looking a little different around here. Our intention with the following “restart our practices plan” is to be able to provide much needed therapies while maintaining safe practices and minimizing the risk of exposure to COVID-19.
Upon reopening of Boulder Mountain Massage Studio, the following procedures will be implemented. It’s a lot of information, but we recommend you read through the information below, and contact us if you have any questions. It is important to understand the risks associated with receiving treatment at this time, and what we can and will do to mitigate those risks.
We understand this will be a strange new way of operating, but we strongly feel that if we are proactive with our safety measures, we will decrease the risk for you and our team. We look forward to providing you with a safe and healing environment!
Your Boulder Mountain Massage Team
Boulder Mountain Massage Studio Restart Plan
Please see link here to Self-Assessment tool: https://bc.thrive.health/covid19/en
Return to Practice During COVID-19 Pandemic
For a safe return to practice our practitioners remain committed to safety protocols in six different practice areas:
1. Good personal practices – Understand how COVID-19 is transmitted and remain committed to behaviours that prevent the spread of COVID-19 both in practice settings and in one’s personal life.
2. Therapist screening –Daily therapist self-monitoring for symptoms and consideration of one’s personal circumstances is important in determining whether working is appropriate.
3. Patient Screening – Every patient is screened carefully to reduce the likelihood of someone coming into the clinic with COVID-19. Further, being aware of the risk factors present with each patient is important. Patients that have new or emerging symptoms of cold or flu are not to be treated, and measures are in place to prevent their attendance in the clinic.
4. Procurement of needed supplies and equipment to make the treatment environment safe.
5. Therapist Infection Control Practices – Factors considered in creating the safest treatment environment possible. The supplies needed to practice safely, the modifications to our treatment environment and cleaning process.
6. Facility practices – Strategies we are implementing to maximize social distancing, keep common areas clean and sanitized and create the safest possible space for patients.
GOOD PERSONAL PRACTICES
A return to work is not a return to normal. It is important that therapists and patients move about in their work and personal environments consciously. These rules apply to everyone as you do your part to help slow the spread of COVID-19.
HOW COVID-19 SPREADS
To minimize personal risk of exposure, everyone should:
For measures on prevention see http://www.bccdc.ca/health-info/diseases-conditions/covid-19/prevention-risks or for a brief summary see: http://www.bccdc.ca/Health-Info-Site/Documents/COVID19-Prevention.pdf
AVOIDING CLOSE CONTACT
COVERING MOUTH AND NOSE
In all scenarios of life, including work, home and public environments, practitioners will:
COVERING COUGHS AND SNEEZES
CLEANING AND DISINFECTING
What we do in our day to day life matters. We recognize that in order to work safely it is important to think ahead about what we can do to stay healthy and prevent the spread of COVID-19 within our practice and our community.
Practitioners commit to:
Symptoms associated with a COVID-19 infection may range significantly and be similar to that of a cold or flu. Both those who are asymptomatic and those who are symptomatic may transmit the virus to others.
Symptoms have included cough, fever, difficulty breathing, and pneumonia in both lungs.
Other symptoms may include muscle aches, fatigue, sore throat, headache, loss of appetite, chills, runny nose, nausea and vomiting, diarrhea, loss of sense of smell or taste.
PRACTITIONER NOT FEELING WELL
Practitioners will not go to work if they are not feeling well – even if their symptoms are mild and they are uncertain of whether it
is COVID-19 or not. Practitioners are committed to protecting their colleagues and their patients and will stay home if there is any doubt in their mind. Practitioners expect to miss more work than usual to make sure that they are taking care of their self, their colleagues, and their community.
Practitioners commit to:
ILLNESS AMONG CLOSE CONTACTS
If a close contact, a spouse, those they live with or their child becomes ill they will stay home and self-isolate with their
family. They will follow the instructions from the BC Centre for Disease Control: http://www.bccdc.ca/Health-Info-Site/Documents/Self-isolation_caregivers.pdf
Practitioners will only return to work when:
PATIENT SCREENING AND ARRIVAL INSTRUCTIONS
After confirming that the therapist is well, careful screening of all visitors that enter the clinic provides an extra level of safety to the clinic, its staff, and patients. Be aware that practice will look and feel different to patients. Clear communication before individuals enter the clinic will help patients understand the new process and what to expect at their visit.
It is imperative that there be a protocol in place so that patients are screened multiple times, including at least one screen prior to arriving at their appointment. Practitioners will ensure 3 screening procedures with each patient for each appointment:
1. At appointment booking, or at appointment reminder email via a screening form or the BC Symptom Self-Assessment Tool
2. During a phone call up to 24 hours prior to the appointment
3. When they first enter the treatment room
Practitioners will document that the screening was done. Practitioners will refuse to treat if their patient refuses to participate in any of the 3 screening processes.
For the safety of all practitioners and patients the patient must answer these questions to the best of their ability. This screening is subject to change as we learn more about Coronavirus and will be updated as such. This screening is based on the BC Symptom Self-Assessment Tool, which practitioners may direct patients to using instead of the clinic online screening form if they choose.
1. Do any of the following apply to yourself, or anyone in your household? Please check all that apply and list the member of your household as well as any other relevant information: Heart conditions, Undergoing cancer treatment, Moderate / severe asthma, A habitual smoker, Chronic lung disease, Poorly controlled HIV / AIDS, Type I or type II diabetes, Severely obese, Liver disease, Over the age of 65, Chronic kidney disease undergoing dialysis, Live in a nursing home or long-term care facility, Recent bone marrow or organ transplantation, Currently pregnant, Corticosteroids / other immune weakening medications use (type and duration), Any other Immune deficiencies or pre-existing conditions (please explain)
Practitioners will discuss the risks versus the benefits of anyone who selected any of the above. The choice to continue with the appointment will only occur when the practitioner and the patient fully understand the nature of the patient’s health condition, the possible added risk of COVID to that patient, and both the practitioner and the patient are comfortable with the precautions in place.
2. Approximately how many social contacts outside your household have you had in the past week? Some examples of a social contact are: getting groceries, going for a walk with a friend, going to work with colleagues also present, etc. (even with social distancing measures taken).
The practitioner will also disclose their social contacts, giving the practitioner and the patient the opportunity to discuss and establish trust in each others’ approach to safety regarding COVID-19.
3. Have you, or has someone in your household, ever been diagnosed with COVID-19? If yes, please list the date of last symptoms.
If the answer is yes and the date is less than 10 days prior to the appointment date, the practitioner will cancel the appointment and re-book the patient in for a date at least 10 days after last symptoms.
4. Have you, or has someone in your household, provided care or had close contact with a person with confirmed or presumed diagnosis of COVID-19? If yes, please list the date of resolution of that patient’s symptoms, or the date of last contact with that patient.
If the answer is yes and the the date of resolution of symptoms, or the date of last contact is less than 14 days prior to the appointment date the practitioner will cancel the appointment and re-book the patient in for a date at least 14 days after resolution of symptoms or last contact.
If yes, AND you are a healthcare provider working with COVID positive patients, have you adhered to strict personal protective equipment protocol? What is your role in working with COVID positive patients?
Practitioners will decide for themselves if they are comfortable treating Healthcare workers who are in direct contact with COVID positive patients. Our doctors and nurses are very well trained in the use of personal protective equipment (PPE) and have strict protocol to follow when PPE fails. Practitioners who do decide to treat said healthcare workers will cancel the appointment if there has been a break in the healthcare workers PPE within 14 days prior to the appointment, OR if the healthcare worker does not meet any other criteria in the screening process. The practitioner will also disclose to ALL patients they are treating that they are treating healthcare workers who are in direct contact with COVID positive patients.
5. Have you, or has someone in your household, traveled outside British Columbia within the last 14 days?
If the answer is yes practitioners will cancel the appointment and re-book the appointment for at least 14 days after the patient’s return home.
6. Are you, or is someone in your household, experiencing any of the following, please check all that apply: Severe difficulty breathing (e.g. struggling to breathe or speaking in single words), Severe chest pain, Having a very hard time waking up, Feeling confused, Losing consciousness, Mild to moderate shortness of breath, Inability to lie down because of difficulty breathing, Chronic health conditions that you are having difficulty managing because of difficulty breathing.
If the answer is yes to any of the above the practitioner will cancel the appointment and direct the patient to do one of the following: call 811, go to https://bc.thrive.health/ or to contact their physician for further guidance and advice. The patient can reschedule later after they are safe to be treated.
7. Are you, or is someone in your household, experiencing any of the following cold, flu or COVID-19-like symptoms, even mild ones? If yes, please note if this is due to an existing condition (provide the name of the condition), or is a regularly experienced symptom. Fever, Chills, Cough, Shortness of breath, Sore throat and painful swallowing, Stuffy or runny nose, Loss of sense of smell, Headache, Unusual muscle aches, Fatigue, Loss of appetite.
If the response to any 2 of these questions is yes, the patient cannot have a treatment. Practitioners will cancel the appointment and direct the patient to do one of the following: call 811, go to https://bc.thrive.health/ or to contact their physician for further guidance and advice. The patient can reschedule later after they are safe to be treated.
PATIENT ARRIVAL AT CLINIC AND INSTRUCTIONS
SUPPLIES CONSIDERATIONS AND PROCUREMENT
The current global risk of COVID-19 has made procurement of many items difficult or impossible. The following considerations have been taken to ensure an environment that is as safe as possible for practitioners, patients, and the public. If items listed, or suitable replacements, can not be found Eaglewind Health will cancel appointments until those items can be procured.
TREATMENT ROOM CONSIDERATIONS
The following furnishing considerations have been implemented:
CLEANING SUPPLIES AND EQUIPMENT
THERAPIST INFECTION CONTROL PRACTICES
From a risk management perspective therapeutic treatment takes place in an enclosed space where the therapist and patient are unable to socially distance. Further cross transmission is a risk given that practitioners will interact with a number of patients in a day. No in person appointment is risk free even if the patient and massage therapist appear well. It is essential that health care
workers are kept healthy, safe, and able to perform their work in providing care and service in all settings. As such practitioners will adhere to the following recommendations and requirements.
The practitioner will:
1. Between every appointment use approved disinfectant in a spray bottle to spray clockwise from the door around the entire treatment room all touch surfaces, including:
2. Between every appointment carry a small spray bottle around with them to disinfect all high touch areas in the common space, including:
3. At least twice daily disinfect the entire common area floor and bathroom on a schedule followed by all practitioners.
4. Launder all linens, blankets, and hand towels after every use.
PERSONAL PROTECTIVE EQUIPMENT (PPE)
Practitioners will place street clothes in an enclosed bin and implement the following PPE protocol:
• Required: Procedural/surgical or cloth masks worn in common areas and changed between treatments.
• Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Safety glasses/goggles or shield
• Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Bibs, clothing covers, scrubs or changes of clothes to be changed between treatments.
• Required: A disposable paper mask for the patient (they can either bring their own or the clinic will provide one for a fee to those who do not have one.
• Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Gloves*
*Note Gloves do not offer any protection over regular and rigorous hand washing that is typical of massage therapy
practice. Gloves are recommended during cleaning, intra-oral work (as per normal practice), and in the case of cuts
or open injuries on the patient or the therapist (as per normal practice). Gloves are always discarded after every
use. If the patient is comforted by the use of gloves, they can be used.
Scheduling considerations for safety:
Our common area is quite small and it is not possible to have a single direction of movement through the hallway, or to maintain 2 meters distance with more than 2 people present at one time.
To reduce the need for prolonged use of our common area and to reduce touch surfaces needing disinfecting, we are implementing the following practices:
Due to the extraordinary circumstances we find ourselves in, no charge of penalties will be levied for cancelled appointments due to patient illness, or due to the patient being denied treatment in the screening process. There will still be a charge of fees for an appointment missed with no notice or explanation of the reason, and for reasons other than illness.
A hand washing sign is placed in the washroom to educate patients on proper hand washing. There are freshly laundered towels provided to dry hands with in a single use with a receptacle for disposal. Touch less trash receptacles and a touch less or easily cleaned soap dispenser is available for use. Washrooms will be more thoroughly cleaned at least twice per day with common contact
points wiped down each time a therapist uses the washroom to wash their own hands.
Contaminated linens can transmit disease via direct contact or by aerosols of contaminated lint generated during sorting, and handling of contaminated items. Practitioners will:
Public Health Agency of Canada [PHAC]. 2016. Routine Practices and Additional Precautions for Preventing the
Transmission of Infection in Healthcare Settings (1-100-22038-0, 978-1-100-22038-3). Retrieved May 2020 from: https://www.rmtbc.ca/wp-content/uploads/2020/04/routine-practices-precautions-healthcare-associated-infections-2016-FINAL-eng.pdf
BC Centre for Disease Control. Accessed May 2020 from: http://covid19.bccdc.ca/
Saskatchewan (April 2020). Re-Open Saskatchewan. A plan to re-open the provincial economy. Saskatchewan.ca/COVID19. Retrieved April 26th from: https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/re-open-saskatchewan-plan/re-open-saskatchewan
Government of Ontario COVID-19 http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_patient_screening_guidance.pdf
Washington State Department of Health COVID-19 Alert for Massage Therapists. Accessed May 11, 2020 from: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVID19LMTRecommendations.pdf