I.P. Work Safe & Wellness COVID-19 Safety Plan for Opening and Maintaining Services May 19th 2020

WE ARE PUTTING OUR CLIENTS AND STAFF HEALTH AND WELL-BEING FIRST 

We want to assure the public that we have taken the appropriate measures to ensure the safety and well-being of our staff, Patients.

COVID-19 response plan: 

Fourth level protection (PPE)

If the first three levels of protection aren’t enough to control the risks, we supply staffs and practitioners with personal protective equipment (PPE), such as non-medical masks. PPE are not used as the only control measure. It will be used in combination with other measures. 

Hygiene, Cleaning and Disinfection 

• We will be sanitizing equipment, all treatment surfaces, washrooms, and public areas on a regular basis and after each treatment. 
• Fraser Health approved; hospital grade disinfectant products are being used in our cleaning protocol. 
  
• Hand Sanitizer and disinfectant wipes have also been provided in the public waiting area. 
• All treatment rooms have access to a sink and soap. Staff are required to wash their hands at least for 20 seconds using appropriate protocols as suggested by world health organization (WHO) before and after treatments and before putting their mask on and before taking the mask off. The staff are also required to wash or sanitize hands after coming into contact with public items. 
• We are using disposable sheets, disposable paper towels, and disposable facial sheets for each client. 

Modify Staff Area and workflow 

• Enforced policy that staff are to stay home when sick. 
• We hold staff meetings virtually through use of teleconference or online meeting technology. 
• Considered staggering start times or developing alternating schedules to reduce the number of people in the workplace at a given time. 
• Prioritized the work that needs to occur at the clinic to offer the services. 
• Arranged staff rooms to adhere to physical distancing guidelines. 
• Minimize the shared use of workstations and equipment where possible. 
• Considered implementing the requirement for staff to have dedicated work clothes and shoes. Provide a place and basckets for staff to safety store their street clothes while working and change in/out of clothes to prevent cross-contamination upon entry and exit from facility. 
• Considered adjusting the general ventilation such as increasing the amount of outdoor air used by the system. Maintain the indoor air temperature and humidity at comfortable levels for building occupants. 
• Provided plastic water bottles in their original packing in case it is needed. We have also removed all product samples, brochures, and business cards. 
  
• Will asked patients and staff to keep communication to a minimum where possible in order to avoid any spread of droplets. 

Scheduling appointment and communicating with Patients 

• Determined how many Patients can be within the clinic at a given time while maintaining at least two metres of physical distance.  
• When speaking with patients during scheduling and appointment reminders, asking clients to consider: 
• Rescheduling if they become sick, are placed on self-isolation, or have travelled out of the country within the last 14 days. 
• Attending appointments alone where possible, and not bring friends or children. 
• Considered emailing the client any forms that need to be filled out  
• Website consideration for posting information on modifications made to the location and appointment visit procedures is in the process. 
• Clients are asked to arrive on time for their appointment. When we are ready for them, we will provide them with the COVID-19 consent form and screening tool to complete (see attached Patient and Staff Consent Profile COVID19 2020-05-15). If any symptoms are identified during the screening procedure, we will require the client to cancel the appointment that day, and rebook when the client is better.  
   
• All staff and clients will have their temperature checked (if needed) by non-contact infrared forehead thermometer and will be denied entry if they have fever (38°C (100°F) or higher). 

Reception

• Posted signage at the entrance of the clinic and within the clinic to assist with communicating expectations, such as physical distancing, reporting illness or travel history, occupancy limit and no entry if unwell or in self-isolation. 
• Considered placing lines on the floor to mark a two metres distance from the reception desk. 
• Considered use of a transparent barrier, such as a plexiglass shield around reception desk, when there is insufficient space to maintain two metre distance between staff and clients. 
• Screened all patients when they check-in for their appointment by asking if they have symptoms associated with COVID-19, have been advised to self-isolate, or have travelled outside of Canada within the last 14 days. Clients that respond in the positive should be asked to leave and reschedule the appointment when deemed clinically appropriate. 
• During transactions, if possible, limited the exchange of papers such as receipts. 
• Where possible, asked patients payments should be accepted through contactless methods. 

Waiting room 

• Arranged the waiting area in a way that allows at least two metres of physical distance between each client.  
• Considered removing extra chairs and coffee tables from the area to support this. 
• Removed unnecessary items and offerings such as magazines, toys, candy, and beverages.  
• Used disposable cups or single use items where necessary. 
• Instructed patients to arrive exact appointment time and no more than five minutes before their expected appointment. 
• Considered alternative approaches, such as asking clients not to enter the clinic until they receive a text message or phone call to advise that their appointment can start. 

Health Services 

• Practitioners and professions covered under the Health Professions Act and additional obligations around clinical care prescribed by their professional colleges. 
• Conducted appointments virtually where clinically appropriate. 
• Conducted a point of care assessment for risk of COVID-19 for every patient interaction. 
• Health services won’t be performed on ill or symptomatic clients, if that is clinically appropriate. 
• Where the client requires timely treatment, ensure PPE is used in accordance with BCCDC guideline. 
• Considered treating only one client at a time to minimize risks associated with moving between two or more patients. 
• Where shared treatment areas exist, we will ensure clients are positioned at least two metres apart and shared equipment is cleaned and disinfected between uses by clients. 
• Wherever possible, each employee should use their own products. If products are shared, they must be cleaned and disinfected between uses. 
• Practiced effective hand hygiene after each client by washing hands with soap and water or using an alcohol-based hand sanitizer. 
• Where feasible, health professionals will avoid sharing equipment or treatment rooms. Treatment rooms should be allocated to a single health professional per shift. 

Preparing next appointment and end of day shift

• Ensuring waiting and treatment areas and, equipment is sanitized to prevent surface transmission between clients. 
• Commonly touched surfaces and shared equipment cleaned and disinfected after contact between individuals, even when not visibly soiled. 
• Towels or any other items contacting a client discarded or laundered between each use. 
• Changed into a separate set of street clothes and footwear before leaving work. 
• Work clothing will place in a bag and laundered after every shift. 
• Recommended shower immediately upon returning home after every shift 

Documentation and Training 

• Provided staff information on the risk of exposure to COVID-19 and the signs and symptoms of the disease. 
• Provided instructions to Staffs on methods for maintaining physical distance, such as not greeting others by hugging or shaking hands. 
• Trained staff on changes we’ve made to work policies, practices, and procedures due to the COVID-19 pandemic. Record keeping of that training. 
• Staff trained on using and doffing PPE. See information regarding use of PPE. 
• Provided up-to-date information on public health officer orders and guidance. Consider daily safety meetings with staff to disseminate any new information. Document these meetings. 
• Trained staff on how to report an exposure to COVID-19. 
• Ensured a process is in place for employees to report concerns.  
• Keeping training records for staff. Examples of training records such as: 
• Using, and doffing personal protective equipment, Training on safe work procedures, N95 respirator fit testing (where applicable). 
• Encouraged staff have completed and have become certified BARBICIDE® Certified by Safe Service Establishment (barbicide.com).