COVID-19 Protocols

COVID-19 protocols guide (for Victoria's protocols, please contact her directly)

Section A: Plan for Return to Clinical Practice (massage therapy)

Section B: Patient Self-Assessment Questionnaire

Section C: What this means for your appointment (massage therapy)

Please be aware that the "Plan for Return to Clinical Practice" and the "Patient Self-Assessment Questionnaire" are fluid documents that may change at any time, pursuant to changes from the CMTBC, the RMTBC, of the office of the PHO. Thank you

A. OUR OFFICIAL PLAN FOR RETURN TO CLINICAL PRACTICE, AS REQUIRED BY THE CMTBC AND PHO, AND WRITTEN IN ACCORDANCE WITH THE INTERIM GUIDELINES PUBLISHED BY CTMBC ON 14 MAY:


Plan for Return to Clinical Practice [2020-05-14] [edited 2020-05-16] [edited 2020-09-07]


Pre-screening:

1- Ensure that the patient understands that while the RMT has taken measures to minimize risk of viral transmission, the nature of massage therapy means that physical distancing is not possible in the treatment room.

2- Advise the patient regarding the use of PPE. (masks, etc)

3- The patient must complete an honest evaluation of the presence of the following symptoms: fever, chills, cough, shortness of breath, sore throat/painful swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches, fatigue, loss of appetite. The patient must answer the following questions:

  • Has the patient limited their contacts and followed the advice of the PHO?

  • Has the patient had extensive contact with individuals outside their immediate family, pod, or unit (other than service workers at grocery stores, banks, other)?

  • Is the patient aware of anyone in their contacts who has COVID-19 symptoms?

4- The patient must not have left BC within the 14 days prior to the appointment

5- The day prior to treatment, the patient must complete the Pre-screening Questionnaire which will be sent in an email, and RMTs must complete the BC Covid-19 Self- Assessment daily.

6- For immunocompromised or at-risk health groups, the patient and RMT must discuss the benefits of treatment, and ensure that the benefits outweigh the risks to the patient’s health


Arrival screening:

1-The patient and RMT must review the steps taken in the pre-screening to ensure that they were completed, and cancel the treatment if the patient does not meet the pre-screening criteria.

2- The patient must be aware that they are empowered to make decisions regarding their own safety in the treatment environment - ex. The patient can ask that the RMT wear gloves or goggles, if the patient so desires.

3- For immunocompromised or at-risk health groups, the RMT may decide to take extra preventative measures even if the patient does not demand them. If the patient does not consent to extra preventative measures (ex does not want the RMT to wear a mask or other PPE), the RMT may cancel the treatment in order to protect the patient.


Physical distancing:

1-The patient must follow the clearly marked lines for direction of travel through the waiting area to ensure 2m of clearance between people.

2-The fabric waiting room chairs will be removed and replace with 2 plastic chairs that can easily be sanitized - these chairs will seldom be used but will be there in case elderly or infirm patients require a place to rest.

3-The patient must arrive unaccompanied unless patient is a minor who requires parent/guardian, or infirm and needs assistance.

4-The patient is required to wait outside the clinic on the second floor breezeway at the area marked with the “WAITING FOR TOWN CENTRE INTEGRATED THERAPIES” sign.

5-The patient will be let in and out by the RMT, who will use sanitized barriers to touch door handles so that the patient touches nothing.

6- Physical distancing is not possible during hands-on treatment, which is why pre-screening, hand hygiene, and enhanced cleaning are essential to minimize risk to all.

7-The clinic will place signage in the common areas of 3041 Anson Ave regarding physical distancing on the stairwells and in the elevator.


Hand Hygiene:

1-The patient must either:

wash their hands with soap and warm water for a minimum of 20 seconds

OR

use alcohol-based hand sanitizer on the fronts and back of both hands

upon arrival to and departure from the clinic.

2- If the patient’s hands are visibly soiled, the patient must wash them with soap and water, not just hand sanitizer.

3- The RMT must wash hands with warm water and soap for a minimum of 20 seconds before and after every treatment, and at any other time when they have touched common surfaces or any potential contaminant.

4- Hand washing protocols must be posted at every sink

5-To prevent handling of money or cards, fully contactless payment can be made by e-transfer to TCITherapies@gmail.com (preferred) or the patient can upload their credit card into our secure Jane Payments feature in their patient profile. Receipts are emailed to the patient.

6- Tissues will be provided in the treatment room so that the patient may open the door without touching the door knob directly.


Face Touching Avoidance:

1-The patient must be reminded that coronavirus can be spread by touch if a person has used their hand/s to cover a cough or a sneeze.

2- The patient should be invited to use tissues supplied by the clinic if they need to touch their face due to a tickle or itch that they need to address. There must be tissues available to the patient in reception, the treatment rooms, and the washroom.

3- The patient must be made aware that proper mask use requires hand sanitizing before and after touching a mask - every time the mask is touched.

4- The RMT must use a hand towel or tissue if they need to touch their face.


Enhanced Cleaning and Sanitizing:

1-Visibly soiled surface must be cleaned immediately and then disinfected.

2-High-touch surfaces (handles, knobs, taps, computers, phones, stools, light switches, counters, chairs..) must be disinfected after every patient, even if they do not appear to be soiled.

3-Linens must continue to be washed in hot soapy water after each use.

4- Sanitizing should be announced and if possible performed in view of patient to reinforce the steps taken to promote the safety of all.

5- Time between patients to thoroughly sanitize will be scheduled, and so a 15-minute buffer will be in place between appointments to allow for sanitizing and for escorting the leaving patient out of the clinic and the arriving patient into the clinic.

6- The treatment table including face cradle and arm rests will continue to be cleaned after each treatment, and the face cradle and arm rests will be sanitized a second time in view of the incoming patient.

7- Thermophores and electrical blankets will no longer be used.

8- Washroom taps, levers, and door handles will be disinfected with Lysol after each use. The washroom will be thoroughly disinfected a minimum of twice daily.

9- If desired, the patient can leave the clinic with a tissue to use as a contact barrier to press the elevator buttons and door handles.


Personal Protective Equipment (PPE):

1-The patient and RMT will both wear masks, if the patient can bring their own, this will be helpful. The RMT will have have clean fabric re-usable masks and single-use disposable masks available for patient use.

2- The RMT will without question wear PPE such as gown, goggles, or gloves as requested by the patient, in order to help the patient feel feel safe.

3- Hands must be washed prior to putting on a mask, prior to removing a mask, and after disposing of a mask in the garbage.

4- The RMT will have single-use vinyl gloves and re-usable (disinfected) goggles if the patient requests their use.


Professional Obligations:

1- The RMT must call Public Health if any patient alleges that they contracted COVID-19 from the RMT.

2- The RMT must then cease practice and self-isolate until Public Health has investigated and provided direction.

3- The RMT must obtain informed consent from the patient acknowledging that:

  • any massage therapy treatment involves some risk of COVID-19 transmission

  • the RMT is following a protocol to reduce or mitigate risk, but that risk cannot be reduced to zero;

  • the patient consents to treatment despite some risk

The RMT then documents the patient’s consent.


B. OUR PATIENT SELF-ASSESSMENT QUESTIONNAIRE, AS REQUIRED BY THE CMTBC AND PHO, AND WRITTEN IN ACCORDANCE WITH THE INTERIM GUIDELINES PUBLISHED BY CTMBC ON 14 MAY, AND COMBINED WITH INFORMED CONSENT TO TREATMENT:


PATIENT SELF-ASSESSMENT QUESTIONNAIRE [2020-05-14] [edited 2020-05-16] [edited 2020-06-10] [edited 2020-09-07]


1-Are you experiencing any of the following: YES/ NO

  • 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


2-Are you experiencing any of the following: YES/ NO

  • 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


3-Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? YES/ NO

Symptoms include: fever, chills, cough, shortness of breath, sore throat and painful swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches, fatigue or loss of appetite.


4-Have you travelled outside BC within the last 14 days? YES/ NO


5-Did you provide care or have close contact with a person with confirmed COVID-19?

Note: This means you would have been contacted by your health authority’s public health team. YES/ NO


6-Are you assessing your risks and taking precautions to protect yourself and those around you in accordance with the PHO and the Chief Medical Officer of Canada (e.g. stay at home if you are unwell, no large gatherings, be physically distant from others, wash hands often, wear a mask in public spaces, etc)? YES/NO


7-Have you had extensive contact with individuals outside your immediate family, pod, or unit (does not include grocery shopping or errands completed with appropriate physically distant procedures, or controlled/stable school cohorts/learning pods)? YES/ NO


8-Are you aware of anyone in your contacts who has COVID-19 symptoms? YES/ NO


Informed consent statement specific to COVID-19 enhanced safety protocols:


I understand that while TOWN CENTRE INTEGRATED THERAPIES (TCIT) has taken measures to minimize the risk of viral transmission, the nature of massage therapy means that physical distancing is not possible in the treatment room. I understand that TCIT has a stringent protocol, following all the guidelines outlined by the RMTBC, the CMTBC, and PHO to mitigate risk, but the risk cannot be reduced to zero. I consent to treatment despite this risk.



___________________ ______________________ ____________

Name (print) signature YYYY/MM/DD






C. What this means for your appointment

  • The day before your appointment you will receive a phone call from us. This will likely occur between 7:00 and 9:00pm to increase the likelihood that you are home, not consuming your evening meal, and have not yet gone to bed. (if there is a more convenient time to call, please let us know and we will do our best to accommodate that). We will run through a pre-screening script with you, and ensure that you have completed the Pre-screening Questionnaire - most of which is directly from the BC COVID-19 Symptom Self-Assessment. Your honest and thoughtful answers are required to maintain the safety of everyone. If you satisfy us that you pass the assessment, your appointment will stand; if not, your appointment will be canceled or rescheduled.

  • Another before-treatment aspect for you to consider is payment: we now only accept contactless payment. Please consider sending an etransfer before your appointment or please add your credit card Information to your patient profile in our Jane booking system - your information is encrypted and we cannot see it. Everything we can do to save time in administrative areas gives you more hands-on time!

  • On the day of your appointment, come to the clinic alone (save for reasons of requiring physical assistance or being a minor child) and be sure to follow the Social Distancing signage regarding the stairwell and elevator. You will be asked to wear a mask in the clinic, so if you have one already, please wear it. Walk out onto the outdoor breezeway (second floor) and wait at the laminated sign telling you to do so until your RMT comes to greet you. The RMT will open all doors for you, so that everything remains contactless.

  • Your RMT will guide you into the clinic, where you will follow the markings on the floor to your choice of hand sanitizer station or sink for hand-washing. If you did not bring a mask, you will now be given one to put on using your newly-sanitized hands.

  • Your RMT will now explain about the transmission of coronavirus via touch, will ensure that you feel empowered to make decisions regarding your own safety, will have you complete a screening and informed consent document, and will decide whether or not treatment can occur. If you are deemed unfit to receive treatment , you will not be charged any fee.

  • Your RMT will bring you into the treatment room, perform any interview and assessment necessary, clean the face cradle and arm rests for a second time in your presence, and then leave the room for you to get ready on the table. The fabric treatment room chairs have been removed and plastic chairs are being used instead. Please place any belongings on the plastic chair and the hexagonal table, because these surfaces can be easily sanitized after you leave.

  • Your RMT will begin and end each hands-on section of the appointment with handwashing in warm and soapy water for 20+ seconds.

  • Since we now only accept contactless payment, at the end of treatment your RMT will charge your credit card for your treatment or ensure that your etransfer has been received, and issue an emailed receipt. No paper receipts will be supplied. If you do not book your own appointments online (preferred, as it saves time), your RMT may also schedule your next appointment at this time.

  • Your RMT will leave the room while you get ready, and attend to any sanitizing or laundry that needs to be addressed while you are getting ready to leave the clinic. When you are ready to leave the treatment room, you will open the door using a tissue as a barrier, remove your fabric mask if you are using clinic-supplied re-usable one, and then use hand sanitizer or warm water and soap to clean your hands before leaving. Your RMT will open the door for you to leave.

  • After you have left, your RMT will sanitize door handles and any surfaces that were touched, put on gloves to remove the used table linens and fabric face mask putting them either directly into the washer or into a basket for soiled linens only, clean the massage table and its face cradle and armrests.