At Hoku Integrated Healthcare we have implemented a COVID-19 safety plan with you and your loved ones in mind. We have devised safety levels of protection that pertain to social distancing in reception areas, instalment of barriers, recognition of new standards of practice required to limit spread of the coronavirus, the wearing of masks, and proper disinfection procedures.
First level protection (elimination): Limit the number of people at the workplace and ensure physical distance whenever possible
- We have established and posted an occupancy limit for our premises. Public Health has advised that the prohibition on gatherings of greater than 50 people refers to “one-time or episodic events” (weddings,public gatherings), and is therefore not intended to apply to workplaces. However, limiting the number of people in a workplace is an important way to ensure physical distancing is maintained. [Public Health has developed guidance for the retail food and grocery store sector that requires at least 5 square metres of unencumbered floor space per person (workers and customers). This allows for variation depending on the size of the facility, and may be a sensible approach for determining maximum capacity for employers from other sectors that do not have specific guidance on capacity from Public Health.]
- In order to reduce the number of people at the worksite, we have considered work-from-home arrangements, virtual meetings, rescheduling work tasks, and limiting the number of customers and visitors in the workplace.
- We have established and posted occupancy limits for common areas.
- We have implemented measures to keep workers and others at least 2 metres apart, wherever possible. Options include revising work schedules and reorganizing work tasks.
Measures in place
Please note this is the Safety Plan for Hoku Integrated Healthcare only. As Langford Massage Therapy shares the same reception area, we have discussed this in detail and information in the document reflects this. The Plan will adapt according to any new information or guidelines provided by the CTCMA, BCCDC (PHO), and WorkSafe should it become available.
- Social distancing is to be followed in the reception area. As distance of 6 feet is to be maintained, a maximum of 3 people are allowed in this area. It should be noted that up to 2 people are most likely to be in this area. Chairs have been removed and signage posted to facilitate this.
- Schedules of massage therapist and acupuncturist are temporarily staggered so that there is anticipated to be no more than 2 people in the reception area at one time. Practitioners are leaving 30 minutes between appointments to facilitate this, and allow time for proper disinfection procedures. Acupuncturist is temporarily not working Tuesdays to reduce flow.
- Acupuncture patients are asked to wait in their cars until called in. Social distancing in the treatment area is maintained during intake except for tongue and pulse diagnosis.
- Patients are asked to arrive alone unless they require assistance.
- Practitioners ask payments be made by direct billing and e-transfer. Acupuncturist also accepts payment by contactless chip reader. Receipts will be emailed when possible.
- If practitioner or patient reports symptoms in office, they are asked to immediately go home and report their symptoms to the BC Health Authority (call 8-1-1) and their primary healthcare provider; patients and practitioners who report symptoms elsewhere are asked to communicate this with their respective practitioner/patient in a timely manner as well. If symptoms are severe, 911 is called.
- Patients who have symptoms of COVID-19 (fever, chills, cough, shortness of breath, sore throat and painful swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches, and/or fatigue or loss of appetite) or who have had these symptoms in the last 14 days, who have travelled outside of Canada in the last 14 days, who have been in close contact with someone with symptoms/diagnosis of COVID-19, or who have been told to self isolate by the BC Health Authority are asked to not attend their appointment.
- Practitioners and patients screen themselves for the above symptoms and requirements before treatment begins. Acupuncturist asks that patients complete the online BC COVID19 assessment tool within 24 hours before visit.
Second level protection (engineering): Barriers and partitions
- We have installed a barrier where workers can’t keep physically distant from co-workers, customers, or others.
- We have included barrier cleaning in our cleaning protocols.
- We have installed the barrier so it doesn’t introduce other risks to workers (e.g., barriers installed inside a vehicle don’t affect the safe operation of the vehicle).
Measures in place
- A plexiglass shield is installed on the front desk and is to be sanitized between patients with a Health Canada approved disinfectant
- PPE is worn by practitioners and patients upon request of the patient
Third level protection (administrative): Rules and guidelines
- We have identified rules and guidelines for how workers should conduct themselves.
- We have clearly communicated these rules and guidelines to workers through a combination of training and signage.
Measures in place
- Practitioners abide by up to date practice standards, recommendations and regulations made by their respective governing bodies (CTCMA, acupuncturist, CMTBC, massage therapist), Government of Canada, Government of BC (via the public health officer), BCCDC, and Worksafe.
- Practitioners disinfect treatment rooms and common areas (if used) between patients.
- Practitioners perform proper handwashing technique, at a frequency of before and after treating patients AND as required to maintain hand sanitation.
- Practitioners and patients do not socialize in the common room.
- Practitioners have met and trained in a cohesive COVID-19 plan prior to opening, where modified policies and procedures have been put into place.
- Practitioners stay home and self isolate for 14 days if symptomatic or test positive for coronavirus. Practitioners notify each other and their patients if the above occurs.
- Handwashing sign, and Help prevent the spread of COVID-19 signs are placed at main entry.
See page 3 and page 7 of this document for more details.
Fourth level protection: Using masks (optional measure in addition to other control measures)
- We have reviewed the information on selecting and using masks and instructions on how to use a mask.
- We understand the limitations of masks to protect the wearer from respiratory droplets. We understand that masks should only be considered when other control measures cannot be implemented.
- We have trained workers in the proper use of masks.
Measures in place
- Face masks are highly recommended. If not wearing one already, practitioners will don a face mask upon request of the patient.
- It is highly recommended to patients to wear a mask to appointments. Masks are provided at the clinic (as long as they are available).
- Practitioners are trained in the proper use of masks. Hands are to be washed before donning the mask, and after removing the mask. Hands are also to be touched if they contact the mask. Surgical masks are disposed of at the end of the day. Cloth masks are used once, washed in hot soapy water and placed in the dryer. If used masks are placed on a surface, careful disinfection of that surface is required.
- Face masks are not a substitue for social distancing.
- If patient is wearing a mask and is asked to reveal their tongue for diagnostic purposes they are directed to wash their hands with 70% alcohol containing disinfectant before donning mask and after doffing mask.
Reduce the risk of surface transmission through effective cleaning and hygiene practices
- We have reviewed the information on cleaning and disinfecting surfaces.
- Our workplace has enough handwashing facilities on site for all our workers. Handwashing locations are visible and easily accessed.
- We have policies that specify when workers must wash their hands and we have communicated good hygiene practices to workers. Frequent handwashing and good hygiene practices are essential to reduce the spread of the virus. Handwashing and Cover coughs and sneezes posters are available at worksafebc.com.
- We have implemented cleaning protocols for all common areas and surfaces — e.g., washrooms, tools, equipment, vehicle interiors, shared tables, desks, light switches, and door handles. This includes the frequency that these items must be cleaned (number of times per day) as well as the timing (before and after shift, after lunch, after use).
- Workers who are cleaning have adequate training and materials.
- We have removed unnecessary tools and equipment to simplify the cleaning process — e.g., coffee makers and shared utensils and plates
- If surfaces/hands appear soiled they are washed with soap and water before sanitizing. Virox(TM), a Health Canada Approved disinfectant is used to clean surfaces. Sani-Hands(TM), a 70% hand sanitizer is used in office.
- Practitioners clean common areas (desk, plexiglass shield, door knobs, chair(s), microwave handle/buttons, water dispenser buttons, door knobs) between each respective patient. Common light switches are cleaned at end of the day.
- Practitioners clean their respective treatment rooms (massage table, head rest, chairs, counter tops, supply containers, foot stools, door knobs, handles, light switches, pens, coat hangers, (Acupuncturist-heat lamp, square chip reader) between patients.
- Cleaning of respective (cell) phones, keyboards occurs at least 3 times a day in morning, lunchtime and before leaving. Garbage is emptied daily by the last person leaving for the day.
- Hands are washed by practitioners (for at least 20 seconds using soap and water or using a disinfectant with 70% alcohol) before treating a patient, after treating a patient, before eating lunch, after using the restroom, after coughing or sneezing into a sleeve, before putting on a face mask, after doffing a face mask, after touching the face, and any other time there is deemed a risk of contamination.
- Hands are washed by patients upon entering the clinic, after using the washroom, after coughing or sneezing, after touching their face, before donning a face mask, after doffing a face mask, upon leaving the clinic, and any other time there is deemed a risk of infection.
- Practitioners open and close doors for patients when possible.
- Tissues are provided for patients and practitioners for “scratching itchy faces”. Paper towels are available in the rest room to act as a barrier when opening and closing the door. Proper hand washing signs are posted in clinic and at the entrance to the restrooms.
- Practitioners have removed clutter and unecessary objects from the office. Bedding is single use only and washed in hot soapy water/dried in dryer. Pillows have plastic covering that can be disinfected.
- Should a practitioner or patient become ill with COVID-19 a thorough cleaning of all surfaces he/she has touched will be performed immediately upon notification off illness.
- Cleaning and Disinfectant poster is in the treatment room.
Document prepared by Angela Berscheid RAc 02183 May 20/20.