Plan for Return to Clinical Practice in Respect of Covid-19 - Updated August 23, 2020
This plan was developed to reduce the risk of exposure to the virus Covid-19 for both patients and the practitioner within my clinical setting. Here, I identify the actions that I commit to, and that all visiting patients must commit to, in order to safely resume massage therapy services. Thank you in advance for your kindness and understanding with all these new measures I'm taking to provide safe and effective care for everyone.
“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-spread
The overall aim of these protocols is to reduce potential coronavirus transmission by:
For Patients & Therapists Pre-Screening / Prior to Arrival
• Patients will be informed about their responsibilities at the time of booking
• 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 therapist will phone the patient one day before their booked appointment to discuss using the self assessment tool and verify that it has been done
• The therapist will use the BC COVID-19 Self-Assessment tool herself, daily and commits to cancelling 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:
• 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 means that physical distancing is not possible in the treatment room.
• 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.
o 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 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
• A freshly laundered cloth face masks is encouraged to wear within the clinic space. If the patient does not have a mask, a single-use mask can be provided
• 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 Entry into Clinic Space
Only 1 patient is permitted in the clinic space at a time. Patients must arrive unaccompanied.
o Unfortunately minors will not be treated at this time
The therapist is the only other person who will be within the clinic space throughout the duration of the patient’s appointment.
• Appointment times are allow for between appointments enhanced cleaning
• Patients are asked to arrive on time and not early or late for appointments.
• The clinic door will be re-opened by the therapist at the end of the appointment for the patient to leave without touching the door knob.
Within the Treatment Room
It is not possible to maintain physical distancing while in the treatment room.
Restroom for Patient Use
The restroom has soap and paper towels for hand washing
Hand Hygiene Reception Area / Entry into Clinic Space
Immediately upon entering the clinic space the patient must either:
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 face mask during hands-on treatment of the patient
• Patients are encouraged to wear a face masks within the clinic space.
• TMJ treatments will not be conducted at this time.
•the face will not be 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 followed by disinfection with a Canada Health Approved for use against Covid-19 disinfectant
• All high touch surfaces will be cleaned and disinfected between patients, regardless of appearances.
High touch surfaces include (but are not limited to):
Personal Protective Equipment
• The therapist will wear an apron and fabric face mask for the hands on portion of the treatment
o Gloves may be appropriate when over-use of cleaning and/or chemicals causes skin irritation, or when the therapist’s hands or skin of the hands are otherwise injured or compromised
o Gloves will be worn by the therapist at the patient’s request.
• Patients are encouraged to bring and wear a cloth face mask in the clinic other wise a single-use disposible mask will be provided, please let me know if you are unable to wear a face mask or feel claustrophobic wearing one
Professional Obligations
Liability Insurance
In the Event That a Patient Tests Positive for COVID-19 Having Been to a Massage Therapy Appointment within the 14- days Prior to Onset of Symptoms
• The patient will contact the therapist and inform her of positive test results and possible transmission of the virus immediately.
• The therapist will immediately self-isolate.
• The therapist will call public health at 8-1-1 to report the possible transmission and act on direction of Provincial Health.
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.
o 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.
In the Event That the Therapist Catches COVID-19 or Displays Symptoms of COVID-19
• The therapist will immediately self-isolate.
• The therapist will call public health at 8-1-1 to report the symptoms and request access to Covid-19 testing
All massage therapy appointments will be cancelled and the Therapist will cease to provide services until test results are returned negative.
If testing proves positive the therapist will follow Public Health directives in informing patients treated over the previous 14 days about potential transmission.
Asymptomatic Spreaders
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; and the RMT will document the patient’s consent in advance and at every treatment
This plan was developed to reduce the risk of exposure to the virus Covid-19 for both patients and the practitioner within my clinical setting. Here, I identify the actions that I commit to, and that all visiting patients must commit to, in order to safely resume massage therapy services. Thank you in advance for your kindness and understanding with all these new measures I'm taking to provide safe and effective care for everyone.
“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-spread
The overall aim of these protocols is to reduce potential coronavirus transmission by:
- Requiring ongoing self-assessment for signs of Covid-19 related illness in both the patient and the therapist
- Reducing all physical, non-treatment related interactions within the practice environment
- Hand hygiene
- Avoiding face touching
- Enhancing cleaning protocols
- Appropriate use of personal protective equipment (PPE)
- Meeting professional obligations, particularly related to informed consent and liability insurance
For Patients & Therapists Pre-Screening / Prior to Arrival
• Patients will be informed about their responsibilities at the time of booking
• 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 therapist will phone the patient one day before their booked appointment to discuss using the self assessment tool and verify that it has been done
• The therapist will use the BC COVID-19 Self-Assessment tool herself, daily and commits to cancelling 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 sense of smell
- sudden headache
- Muscle aches
- Fatigue
- Loss of appetite
• 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 means that physical distancing is not possible in the treatment room.
• 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.
o 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 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
• A freshly laundered cloth face masks is encouraged to wear within the clinic space. If the patient does not have a mask, a single-use mask can be provided
• 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 Entry into Clinic Space
Only 1 patient is permitted in the clinic space at a time. Patients must arrive unaccompanied.
o Unfortunately minors will not be treated at this time
The therapist is the only other person who will be within the clinic space throughout the duration of the patient’s appointment.
• Appointment times are allow for between appointments enhanced cleaning
• Patients are asked to arrive on time and not early or late for appointments.
• The clinic door will be re-opened by the therapist at the end of the appointment for the patient to leave without touching the door knob.
Within the Treatment Room
It is not possible to maintain physical distancing while in the treatment room.
Restroom for Patient Use
The restroom has soap and paper towels for hand washing
Hand Hygiene Reception Area / Entry into Clinic Space
Immediately upon entering the clinic space the patient must either:
- Go directly to the washroom sink 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 space
- If hands are visibly soiled, the patient must wash hands at the washroom sink
- The therapist will wash hands thoroughly for at least 20 seconds between patients, before and after disinfecting spaces, before donning gloves and after taking gloves off, and before donning other PPE
- Cash or cheques will not be accepted at this time. E-transfer (EMT) or email invoice to be paid by credit card at home by the patient in order for them to pay it online.
- Receipts will be emailed upon payment
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 face mask during hands-on treatment of the patient
• Patients are encouraged to wear a face masks within the clinic space.
• TMJ treatments will not be conducted at this time.
•the face will not be 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 followed by disinfection with a Canada Health Approved for use against Covid-19 disinfectant
• 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, table surfaces, chairs, stools etc.
- The treatment table, face cradle, oil bottles will be immediately after each treatment.
- All linens, including blankets and pillow cases are single use only and will be laundered as usual using hot water, detergent and high-heat steam sanitary steam dryer cycle between each use
- Weather permitting clinic windows will remain open during treatment to allow good air flow
Personal Protective Equipment
• The therapist will wear an apron and fabric face mask for the hands on portion of the treatment
o Gloves may be appropriate when over-use of cleaning and/or chemicals causes skin irritation, or when the therapist’s hands or skin of the hands are otherwise injured or compromised
o Gloves will be worn by the therapist at the patient’s request.
• Patients are encouraged to bring and wear a cloth face mask in the clinic other wise a single-use disposible mask will be provided, please let me know if you are unable to wear a face mask or feel claustrophobic wearing one
Professional Obligations
Liability Insurance
- The therapist carries professional liability insurance through Wilson M. Beck as provided through the Registered Massage Therapist Association of BC.
- The therapist is following all the health and safety guidelines outlined by the Registered Massage Therapists Association of BC, the College of Massage Therapists of British Columbia and the Provincial Health Officer and that they are taking all reasonable precautions to clean and disinfect the clinic and all the surfaces within the treatment room.
- No guarantees have been made by the therapist, that the patient may not come in contact with COVID-19 at or during an appointment.
In the Event That a Patient Tests Positive for COVID-19 Having Been to a Massage Therapy Appointment within the 14- days Prior to Onset of Symptoms
• The patient will contact the therapist and inform her of positive test results and possible transmission of the virus immediately.
• The therapist will immediately self-isolate.
• The therapist will call public health at 8-1-1 to report the possible transmission and act on direction of Provincial Health.
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.
o 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.
In the Event That the Therapist Catches COVID-19 or Displays Symptoms of COVID-19
• The therapist will immediately self-isolate.
• The therapist will call public health at 8-1-1 to report the symptoms and request access to Covid-19 testing
All massage therapy appointments will be cancelled and the Therapist will cease to provide services until test results are returned negative.
If testing proves positive the therapist will follow Public Health directives in informing patients treated over the previous 14 days about potential transmission.
Asymptomatic Spreaders
- Asymptomatic transmission of the coronavirus is an unavoidable risk of practice
- 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; and the RMT will document the patient’s consent in advance and at every treatment