Trimetrics Physiotherapy Clinical Pilates and Complementary Health Clinic
Protocols for Health Care Practitioners

Hygiene, cleaning, and disinfection 

  • Ensure adequate hand washing facilities are available, and provide alcohol-based hand sanitizers approved by Health Canada(DIN or NPN number).
  • Encourage staff and clients to practice hand hygiene upon entering and exiting the clinic.
  • Identify all common areas (e.g., washrooms, lunchrooms) and high contact surfaces (e.g., door handles, stair rails) and develop and implement a cleaning and disinfection schedule and associated procedures.
  • Ensure shared equipment and facilities (e.g., telephones, computers, washrooms and laundry rooms) receive increased cleaning and sanitizing.
  • Develop and implement protocols for sanitizing treatment areas and equipment to prevent surface transmission between clients.
  • Provide staff training to ensure safe handling and effective application of cleaning products.

Modify staff areas and work flow

  • Work remotely whenever possible.
  • Develop and enforce policy that staff are to stay home when sick.
  • Hold staff meetings virtually through use of teleconference or online meeting technology.
  • Where in-person meetings are required, ensure staff members are positioned at least two metres apart.
  • If work in the office/clinic is required, consider staggering start times or developing alternating schedules to reduce the number of people in the workplace at a given time.
  • To minimize the number of co-workers that staff are interacting with, consider creating teams or groupings of health professionals and scheduling them to regularly work together.
  • Prioritize the work that needs to occur at the workplace for you to offer your services.
  • Arrange staff rooms and break rooms to adhere to physical distancing guidelines.
  • Consider staggered break times to reduce employee gathering numbers.
  • Minimize the shared use of workstations and equipment where possible.
  • Consider implementing the requirement for staff to have dedicated work clothes and shoes. Provide a place 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.
  • Consider 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.
  • For additional considerations, refer Offices: Protocols for returning to operation.

Scheduling appointments and communicating with clients

  • Determine how many clients can be within the clinic at a given time while maintaining at least two metres of physical distance. Do not book appoints above this number.
  • In order to accommodate physical distancing, appointment times may need to be staggered.
  • When speaking with clients during scheduling and appointment reminders, ask 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.
  • Consider emailing the client any forms that need to be filled out so clients can complete them prior to arriving at the clinic.
  • Clinics with a website should consider posting information on modifications made to the location and appointment visit procedures.

Reception

  • Post signage at the entrance of the clinic and within the clinic to assist with communicating expectations, such as hand hygiene, physical distancing, respiratory etiquette, reporting illness or travel history, occupancy limitsand no entry if unwell or in self-isolation.
  • Consider placing lines on the floor to mark a two metres distance from the reception desk.
  • Consider 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.
  • Screen all clients 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, limit the exchange of papers such as receipts.
  • Where possible, payments should be accepted through contactless methods.


Waiting area

  • Arrange the waiting area in a way that allows at least two metres of physical distance between each client. Consider removing extra chairs and coffee tables from the area to support this.
  • Remove unnecessary items and offerings such as magazines, toys, candy, and beverages. Use disposable cups or single use items where necessary.
  • Instruct clients to arrive no more than five minutes before their expected appointment.
  • Where room size or layout presents challenges to physical distancing, consider 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.

Provision of health services

Professions covered under the Health Professions Act may have additional obligations around clinical care prescribed by their professional college. See the section below for links to those professional colleges.

  • Conduct appointments virtually where clinically appropriate.
  • Conduct a point of care assessment for risk of COVID-19 for every client interaction.
  • Health services should not 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 guidance.
  • When possible, the health professional should position themselves at least two metres from the client.
  • Consider treating only one client at a time to minimize risks associated with moving between two or more patients.
  • Where shared treatment areas exist, 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.
  • Practice effective hand hygiene after each client by washing hands with soap and water or using an alcohol-based hand sanitizer approved by Health Canada(DIN or NPN number).
  • Where feasible, health professionals should avoid sharing equipment or treatment rooms. Treatment rooms should be allocated to a single health professional per shift.


Health professionals: Protocols for returning to operation

These protocols provide guidance to health professionals. Those professions covered under the Health Professions Act may have additional obligations around clinical care prescribed by their professional college. Links to applicable professional colleges are provided under Additional Resources below.

Health professional employers may also benefit from reviewing protocols for in-person counselling and office spaces. Employers must also ensure they are abiding by any relevant orders, notices, or guidance issued by the provincial health officer and the health authority relevant to their workplace.

  • Developing a COVID-19 safety plan
  • Understanding the risk
  • Selecting protocols for your workplace
  • Protocols for health professionals
  • For more information
  • Resources

Developing a COVID-19 safety plan

Employers resuming operations are required to develop a COVID-19 Safety Plan that outlines the policies, guidelines, and procedures they have put in place to reduce the risk of COVID-19 transmission. This plan follows the six steps outlined on the COVID-19 and returning to safe operation. Employers must involve frontline workers, joint health and safety committees, and supervisors in identifying protocols for their workplace. You do not need a formal plan in place to begin operation, but are expected to develop it while protecting the safety of your workers.

WorkSafeBC will not be reviewing or approving the plans of individual employers, but in accordance with the order of the Provincial Health Officer, this plan must be posted at the worksite. During a WorkSafeBC inspection, we will ask employers about the steps they have taken to protect their workers or to see the plan if it has been developed.

One part of developing your COVID-19 Safety Plan is identifying protocols that everyone at the workplace must follow to keep workers safe. We’ve provided industry-specific protocols below to use as you develop the plan for your workplace.

These protocols are not a list of requirements; however, they should be considered and implemented to the extent that they address the risks your workplace. You may need to identify and implement additional protocols if these do not sufficiently address the risk to your workers.

Understanding the risk

The virus that causes COVID-19 spreads in several ways, including through droplets when a person coughs or sneezes, and from touching a contaminated surface before touching the face. Higher risk situations require adequate protocols to address the risk.

  • The risk of person-to-person transmission is increased the closer you come to other people, the amount of time you spend near them, and the number of people you come near.
  • The risk of surface transmission is increased when many people contact same surface, and when those contacts happen in short intervals of time.

Selecting protocols for your workplace

Note that different protocols offer different protection. Wherever possible, use the protocols that offer the highest level of protection and add additional protocols as required.

First level protection (elimination): Use policies and procedures to keep people at a safe physical distance from one another. Limit the number of people in your workplace at any one time, and implement protocols to keep workers at least 2 metres from other workers, customers, and members of the public.

Second level protection (engineering controls): If you can’t always maintain physical distancing, install barriers such as plexiglass to separate people.

Third level protection (administrative controls): Establish rules and guidelines, such as cleaning protocols, telling workers to not share tools, or implementing one-way doors or walkways.

Fourth level protection (PPE): If the first three levels of protection aren’t enough to control the risks, supply workers with personal protective equipment (PPE), such as non-medical masks. PPE should not be used as the only control measure. It should only be used in combination with other measures.

Protocols for health professionals

Hygiene, cleaning, and disinfection 

  • Ensure adequate hand washing facilities are available, and provide alcohol-based hand sanitizers approved byHealth Canada (DIN or NPN number).
  • Encourage staff and clients to practice hand hygiene upon entering and exiting the clinic.
  • Identify all common areas (e.g., washrooms, lunchrooms) and high contact surfaces (e.g., door handles, stair rails) and develop and implement a cleaning and disinfection schedule and associated procedures.
  • Ensure shared equipment and facilities (e.g., telephones, computers, washrooms and laundry rooms) receive increased cleaning and sanitizing.
  • Develop and implement protocols for sanitizing treatment areas and equipment to prevent surface transmission between clients.
  • Provide staff training to ensure safe handling and effective application of cleaning products.

Modify staff areas and work flow

  • Work remotely whenever possible.
  • Develop and enforce policy that staff are to stay home when sick.
  • Hold staff meetings virtually through use of teleconference or online meeting technology.
  • Where in-person meetings are required, ensure staff members are positioned at least two metres apart.
  • If work in the office/clinic is required, consider staggering start times or developing alternating schedules to reduce the number of people in the workplace at a given time.
  • To minimize the number of co-workers that staff are interacting with, consider creating teams or groupings of health professionals and scheduling them to regularly work together.
  • Prioritize the work that needs to occur at the workplace for you to offer your services.
  • Arrange staff rooms and break rooms to adhere to physical distancing guidelines.
  • Consider staggered break times to reduce employee gathering numbers.
  • Minimize the shared use of workstations and equipment where possible.
  • Consider implementing the requirement for staff to have dedicated work clothes and shoes. Provide a place 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.
  • Consider 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.
  • For additional considerations, referOffices: Protocols for returning to operation.

Scheduling appointments and communicating with clients

  • Determine how many clients can be within the clinic at a given time while maintaining at least two metres of physical distance. Do not book appoints above this number.
  • In order to accommodate physical distancing, appointment times may need to be staggered.
  • When speaking with clients during scheduling and appointment reminders, ask 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.
  • Consider emailing the client any forms that need to be filled out so clients can complete them prior to arriving at the clinic.
  • Clinics with a website should consider posting information on modifications made to the location and appointment visit procedures.

Reception

  • Post signage at the entrance of the clinic and within the clinic to assist with communicating expectations, such as hand hygiene, physical distancing, respiratory etiquette, reporting illness or travel history, occupancy limits and no entry if unwell or in self-isolation.
  • Consider placing lines on the floor to mark a two metres distance from the reception desk.
  • Consider 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.
  • Screen all clients 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, limit the exchange of papers such as receipts.
  • Where possible, payments should be accepted through contactless methods.

Waiting area

  • Arrange the waiting area in a way that allows at least two metres of physical distance between each client. Consider removing extra chairs and coffee tables from the area to support this.
  • Remove unnecessary items and offerings such as magazines, toys, candy, and beverages. Use disposable cups or single use items where necessary.
  • Instruct clients to arrive no more than five minutes before their expected appointment.
  • Where room size or layout presents challenges to physical distancing, consider 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.

Provision of health services

Professions covered under the Health Professions Act may have additional obligations around clinical care prescribed by their professional college. See the section below for links to those professional colleges.

  • Conduct appointments virtually where clinically appropriate.
  • Conduct a point of care assessment for risk of COVID-19 for every client interaction.
  • Health services should not 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 guidance.
  • When possible, the health professional should position themselves at least two metres from the client.
  • Consider treating only one client at a time to minimize risks associated with moving between two or more patients.
  • Where shared treatment areas exist, 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.
  • Practice effective hand hygiene after each client by washing hands with soap and water or using an alcohol-based hand sanitizer approved by Health Canada (DIN or NPN number).
  • Where feasible, health professionals should avoid sharing equipment or treatment rooms. Treatment rooms should be allocated to a single health professional per shift.

Preparing for next appointment/end of day

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

Documentation and training

  • Provide your staff information on the risk of exposure to COVID-19 and the signs and symptoms of the disease.
  • Provide instructions to workers on methods for maintaining physical distance, such as not greeting others by hugging or shaking hands.
  • Train your staff on changes you’ve made to work policies, practices, and procedures due to the COVID-19 pandemic. Keep records of that training.
  • Workers must be trained on donning, using and doffing PPE. See information regarding use of PPE.
  • Provide 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.
  • Train your staff on how to report an exposure to COVID-19.
  • Ensure a process is in place for employees to report concerns and for employers to address them, and that worker reps or joint health and safety committees are in place where required.
  • Keep training records for staff. Examples of training records may include:
    • Donning, using, and doffing personal protective equipment
    • Training on safe work procedures
    • N95 respirator fit testing (where applicable)