At Actin Physio, we are dedicated to ensuring not only the health and wellbeing of our clients, but also their safety. Per the Workers Compensation Board of British Columbia, we are following their recommendations and changing our business to ensure the safety of our staff and our clients.
Step 1: Assess the risks at your workplace
The virus that causes COVID-19 spreads in several ways. It can spread in droplets when a person coughs or sneezes. It can also spread if you touch a contaminated surface and then touch your face. The risk of person-to-person transmission increases the closer you come to other people, the more time you spend near them, and the more people you come near. The risk of surface transmission increases when many people contact the same surface and when those contacts
happen over short periods of time.
Involve workers when assessing your workplace. Identify areas where there may be risks, either through close physical proximity or through contaminated surfaces. The closer together workers are and the longer they are close to each other, the greater the risk.
- We have involved frontline workers, supervisors, and the joint health and safety committee (or worker health
- and safety representative, if applicable).
- We have identified areas where people gather, such as break rooms, production lines, and meeting rooms.
- We have identified job tasks and processes where workers are close to one another or members of the public.
- This can occur in your workplace, in worker vehicles, or at other work locations (if your workers travel offsite as
- part of their jobs).
- We have identified the tools, machinery, and equipment that workers share while working.
- We have identified surfaces that people touch often, such as doorknobs, elevator buttons, and light switches
Step 2: Implement protocols to reduce the risks
Select and implement protocols to minimize the risks of transmission. Look to the following for information, input, and guidance:
- Review industry-specific protocols on worksafebc.com to determine whether any are relevant to your industry.
- Guidance for additional sectors will be posted as they become available. If protocols are developed specific to your sector, implement these to the extent that they are applicable to the risks at your workplace. You may need to identify and implement additional protocols if the posted protocols don’t address all the risks to your workers.
- Frontline workers, supervisors, and the joint health and safety committee (or worker representative).
- Orders, guidance, and notices issued by the provincial health officer and relevant to your industry.
- Your health and safety association or other professional and industry associations.
Reduce the risk of person-to-person transmission
To reduce the risk of the virus spreading through droplets in the air, implement protocols to protect against your identified risks. Different protocols offer different levels of protection. Wherever possible, use the protocol that offers the highest level of protection. Consider controls from additional levels if the first level isn’t practicable or does not completely control the risk. You might likely need to incorporate controls from various levels to address the risk at your workplace.
First level protection (elimination):
Limit the number of people at the workplace and ensure physical distance
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 such as break rooms, meeting rooms, change rooms, washrooms, and elevators.
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.
Actin Physio has performed the following to accomodate the above:
- Revised work schedule that reduces the number practitioners accepting patients in the clinic at one time.
- Increased time between patient appointments to reduce the number of people in the clinic at one time.
- Patients instructed not to enter clinic until 5 minutes before the start of their appointment.
- Patients will be able to self check-in using a QR code posted on the front door of the clinic. This is to reduce the need for people to arrive early for check-in and eliminate the need to aggregate at the reception desk.
- Limit of two people per treatment room at any one time. This would only allow for the healthcare provider and the patient to be in a treatment room at one time (this may not always be possible as outlined under # 6 below).
- Encourage patients to attend appointments alone (we acknowledge there are situations that might require a patient to have another person present for the appointment).
- Waiting area has been eliminated. All seating in the waiting area has been removed. Coffee, tea, water, beverages, and magazines are no longer offered in our facility.
- Encourage electronic charting, report writing, and administrative tasks to be completed remotely whenever feasible.
Second level protection (engineering): Barriers and partitions
We have installed barriers 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 barriers so they don’t introduce other risks to workers (e.g., barriers installed inside a vehicle don’t affect the safe operation of the vehicle).
Additional steps at Actin Physio include:
- Plexiglass barriers at the reception desk.
- No touch payment system that will slide under plexiglass barrier to allow for credit card payment.
- Direct billing to many insurers. This reduces the need to collect payment directly from patients.
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.
Additional measures taken at Actin Physio include:
- Signage and floor decal instructing patients how far to stand from reception desk.
- Signage directing patients to proceed to their assigned treatment rooms upon entering the facility. This eliminates the need for staff to leave walk patients to their treatment room and reduces overall movement of people within the facility.
- Signage instructing people to maintain a two meter distance from others whenever possible (we acknowledge this may not be possible during the delivery of certain types of treatment).
- Conduct COVID-19 pre-screening (see # 5 below) on phone at the time of booking. COVID-19 screening will be completed again via electronic survey within 24 hours of scheduled appointment time.
- Screening patients for all of the following: a) symptoms associated with COVID-19, b) travel or contact with anyone who has travelled within 14 days of their appointment, c) close contact with anyone with respiratory illness or confirmed / suspected case of COVID-19, d) use of required and/or recommended PPE when had close contact with suspected or confirmed case of COVID-19 (if applicable).
- Eliminate online booking as it is not possible to pre-screen patients as outlined above through online booking.
- Distribute receipts, statements of account, appointment reminders, patient intake questionnaires, and home exercise programs electrically unless a patient requests hard-copy of these documents. This is done to reduce handling of paper that is passed between people.
- Treatment rooms are allocated to a single health professional per shift.
- Schedule to treat only one patient at a time to minimize risks associated with moving between two or more patients
- Staff are encouraged to change into a separate set of street clothes and footwear before leaving work. A changing area is available for staff use in our facility.
- Work clothing should be placed in a bag and laundered after every shift. A storage space for clothing is available for staff use.
- Staff are encouraged to shower immediately upon returning home after every shift.
- Staff are kindly asking all clients to wash their hands at the washing station upon entry into the clinic before entering clinic rooms or operating gym equipment
- Staff are requesting all clients to wash their hands at the washing station after their appointment before leaving the clinic
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.
Face shields for interactions with patients when the healthcare provider can not maintain two meters of distance from his/her patient.
Surgical masks for interactions with patients when the healthcare provider can not maintain two meters of distance from his/her patient.
Employees who do not work in close proximity (ie. administrative staff) to others may wear masks and face shields as a matter of personal choice.
Patients will be required to wear masks to their appointment to prevent spread of respiratory droplets.
When physical distancing can not be maintained, patients will be required to wear masks for to protect workers. Workers should also wear masks to protect patients.
Additional actions taken at Actin Physio include:
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
- The administrative staff member on duty during a particular shift will be in charge of cleaning and disinfecting.
- Regular cleaning of the following after each appointment: treatment beds, door handles, light switches, any exercise equipment used during an appointment, medical cart handles.
- Disinfect washroom door handle and main exterior door handle two times per shift
- All staff will wash hands upon entering the facility and again prior to leaving the facility.
- Equipment such as keyboards, mouse, telephone, and wireless headset will be disinfected prior to starting work by the administrative staff on duty during a particular shift. This equipment will not be shared with other staff for the duration of the shift.
- Practice effective hand hygiene after each patient by washing hands with soap and water or using an alcohol-based hand sanitizer.
- Towels or any other items contacting a client are to be discarded or laundered between each use.
- Enhanced cleaning of high touch surfaces and shared equipment.
Step 3: Develop policies
- Develop the necessary policies to manage your workplace, including policies around who can be at the workplace, how to address illness that arises at the workplace, and how workers can be kept safe in adjusted working conditions.
- Our workplace policies ensure that workers and others showing symptoms of COVID-19 are prohibited from the workplace.
- Anyone who has had symptoms of COVID-19 in the last 10 days. Symptoms include fever, chills, new or worsening cough, shortness of breath, sore throat, and new muscle aches or headache.
- Anyone directed by Public Health to self-isolate.
- Anyone who has arrived from outside of Canada or who has had contact with a confirmed COVID-19 case must self-isolate for 14 days and monitor for symptoms.
- Visitors are prohibited or limited in the workplace.
- First aid attendants have been provided OFAA protocols for use during the COVID-19 pandemic.
- We have a working alone policy in place (if needed).
- We have a work from home policy in place (if needed).
- Ensure workers have the training and strategies required to address the risk of violence that may arise as customers and members of the public adapt to estrictions or modifications to the workplace. Ensure an appropriate violence prevention program is in place.
Our policy addresses workers who may start to feel ill at work. It includes the following:
- Sick workers should report to first aid, even with mild symptoms.
- Sick workers should be asked to wash or sanitize their hands, provided with a mask, and isolated. Ask the worker to go straight home. [Consult the BC COVID-19 Self-Assessment Tool, or call 811 for further guidance related to testing and self-isolation.]
- If the worker is severely ill (e.g., difficulty breathing, chest pain), call 911.
- Clean and disinfect any surfaces that the ill worker has come into contact with.
Step 4: Develop communication plans and training
You must ensure that everyone entering the workplace, including workers from other employers, knows how to keep themselves safe while at your workplace.
We have a training plan to ensure everyone is trained in workplace policies and procedures.
- All workers have received the policies for staying home when sick.
- We have posted signage at the workplace, including occupancy limits and effective hygiene practices.
- [A customizable occupancy limit poster and handwashing signage are available on worksafebc.com.]
- We have posted signage at the main entrance indicating who is restricted from entering the premises, including visitors and workers with symptoms.
- Supervisors have been trained on monitoring workers and the workplace to ensure policies and procedures are being followed.
Step 5: Monitor your workplace and update your plans as necessary
Things may change as your business operates. If you identify a new area of concern, or if it seems like something isn’t working, take steps to update your policies and procedures. Involve workers in this process.
- We have a plan in place to monitor risks. We make changes to our policies and procedures as necessary.
- Workers know who to go to with health and safety concerns.
- When resolving safety issues, we will involve joint health and safety committees or worker health and safety representatives (or, in smaller workplaces, other workers).
Step 6: Assess and address risks from resuming operations
If your workplace has not been operating for a period of time during the COVID-19 pandemic, you may need to manage risks arising from restarting your business.
- We have a training plan for new staff.
- We have a training plan for staff taking on new roles or responsibilities.
- We have a training plan around changes to our business, such as new equipment, processes, or products.
- We have reviewed the start-up requirements for vehicles, equipment, and machinery that have been out of use.
- We have identified a safe process for clearing systems and lines of product that have been out of use.