Myokinetics RMT: Quick Reference for COVID-19 Return to Clinical Practice Plan

 The College of Massage Therapists of BC, with the consent of the Provincial Health Officer, has announced the Interim Guidelines for RMTs to resume practice in BC.  The CMT required us to create a Plan for Return to Clinical Practice that addresses all aspects of the Interim Guidelines (see www.cmtbc.ca for the full document) and to share that Plan with you, our patients.

The document in full will be posted below as well as on our website but please note:

  1. Your RMT is required to call you the day before your appointment to connect personally with you and to remind you to take the BC COVID 19 Self-Assessment Tool. We will attempt to make these calls in the evening between 7:00pm and 9:30pm, so that it is not too late and disruptive to people. If you miss the call please call your RMT back at the number they have left for you.
  1. The pre-screening the day before your appointment and the screening that will happen when you arrive for your appointment are integral aspects to keeping everyone safe.  Since we will be directly touching you, our main form of protection is honest and accurate screening of our patients.  Please respect the screening process.

**Symptoms of COVID-19 are similar to other respiratory illnesses and seasonal allergies**

Symptoms include:

    •  fever
    • chills
    • cough
    • shortness of breath
    • sore throat/painful swallowing
    • loss of sense of smell
    • excessive fatigue
    • stuffy, runny nose (seasonal allergies)
    • headaches or muscle aches not related to injury that present like flu like symptoms                                                                                                           

*With the guidance of 8-1-1 all healthcare workers currently working on a COVID-19 ward are currently not permitted to receive massage therapy at this time

*With accordance of 8-1-1 any healthcare workers not working on a COVID-19 ward, but have potentially come in contact, directly or indirectly, with a COVID-19 patient must not book a appointment until 14 days after regardless of symptoms that may not be present, according to 8-1-1

*Anyone with seasonal allergies is not permitted to receive massage therapy at this time since the symptoms mimic COVID-19 and are recommended to get tested according to 8-1-1

An appointment must be cancelled immediately if you present with even mild symptoms that may be signs of COVID-19.

COVID-19 symptoms may range from mild to severe. You are required to cancel appointments if you experience what you determine to be ‘just the sniffles’, ‘seasonal allergies’ or ‘just feeling under the weather’, on the day of their appointment.

The patient must also answer the following question honestly: Is the patient aware of anyone in their contacts who have COVID-19 symptoms?

  1. To receive treatment the patient must not have left BC within the previous 14 days
  1. Late cancellation fees will be waived due to illness
  1. We require each patient to wear a mask. If you have a mask please bring it and wear it upon arrival (masks are available upon request at no additional cost). If you have any concerns about wearing a mask this can be discussed case-by-case.
  1. You may not enter the clinic until your RMT has called or texted.When you arrive to your appointment check-in through our online mobile check-in service by visiting janeapp.com/checkin and using your online profile that you made the appointment with. Please wait in your car or outside socially distanced (6 feet/2 meters) from others. If you have not received a call/text message from your therapist 5 minutes past your appointment time please call the clinic at 604-474-2282. Please make sure your phone number is up to date in our online booking system.
  1. You must arrive unaccompanied, unless you are a minor or need physical assistance to get to the clinic.
  1. You are required to use the automatic hand sanitizer immediately after entering and before departing the clinic.
  1. You are required to have your temperature taken upon arrival and some therapists may also choose to check your oxygen levels using a fingertip pulse oximeter.
  1. If any payment is under $100 please use tap/contactless feature. All receipts will be e-mailed to patients and cash is not permitted at this time.
  1. As of May 19th 2020, all massage therapy sessions have increased by $5 due to the increased cost of cleaning supplies and equipment effective as of May 19th 2020

Our full Plan for Return to Clinical Practice is included below.  Please read it so that you know what to expect at your next appointment, and don’t lose time out of your treatment having these steps explained to you.  We are relying on you to help us make the return to practice as smooth as possible.

Myokinetics: Detailed COVID-19 Return to Clinical Practice Plan

PRE-SCREENING – PRIOR TO ARRIVAL

  1. Clear information about patients’ responsibilities will be included on our website, online booking system, and phone message.
  1. The RMT will ask for informed consent from the patient so that the patient understands that while we have taken measures to minimize risk of viral transmission, the nature of massage therapy means that physical distancing is not possible in the treatment room. The RMT will explain both the risks and the potential benefits of treatment, and will make decisions about treatment.
  1. The RMT will call the patient one day prior to their appointment to ask them to complete the BC COVID-19 Symptom Self-Assessment that can be found at https://bc.thrive.health. RMT’s will walk the patient through some of the pre-screening questions, including information about recent travel. The patients are required to complete an honest evaluation about experiencing any symptoms of COVID-19.
  1. Symptoms of COVID-19 are similar to other respiratory illnesses and seasonal allergies.

Symptoms include:

    • Fever
    • Chills
    • cough
    • shortness of breath
    • sore throat/painful swallowing
    • loss of sense of smell
    • excessive fatigue
    • stuffy, runny nose (seasonal allergies)
    • headaches or muscle aches not related to injury that present like flu like symptoms                                                                                                           

*With the guidance of 8-1-1 all healthcare workers currently working on a COVID-19 ward are currently not permitted to receive massage therapy at this time

*With accordance of 8-1-1 any healthcare workers not working on a COVID-19 ward, but have potentially come in contact, directly or indirectly, with a COVID-19 patient must not book a appointment until 14 days after regardless of symptoms that may not be present, according to 8-1-1

*Anyone with seasonal allergies is not permitted to receive massage therapy at this time since the symptoms mimic COVID-19 and are recommended to get tested according to 8-1-1

An appointment must be cancelled immediately if either the patient or the RMT presents with even mild symptoms that may be signs of COVID-19.

COVID-19 symptoms may range from mild to severe. Patients are required to cancel appointments if they experience what they determine to be ‘just the sniffles’, ‘seasonal allergies’ or ‘just feeling under the weather’, on the day of their appointment. If the patient has experienced any of the symptoms they are asked to stay home and are recommended to call 8-1-1.

  1. The patient must also answer the following question honestly
  • Is the patient aware of anyone in their contacts who have COVID-19 symptoms?
  1. To receive treatment the patient must not have left BC within the previous 14 days.
  1. We require each patient to wear a mask. If you have a mask please bring it and wear it upon arrival (masks are available upon request at no additional cost). If you have any concerns about wearing a mask this can be discussed case-by-case.
  1. RMT’s and clinic staff will use the BC COVID-19 self-assessment tool as well as check and record their temperature daily, and stay home/cancel appointments if experiencing COVID-19 symptoms.
  1. The cancellation policy will be waived for all patients that have any COVID-19 or flu like symptoms.
  1. If the patient is immunocompromised or part of an at-risk health group, the RMT and patient will converse prior to treatment to ensure that the benefits of treatment outweigh the risks to the patient’s health. The RMT may choose to postpone treatment or refer to alternate care if possible.

UPON ARRIVAL

  1. The patient must arrive unaccompanied unless the patient is a minor who requires parent/guardian, or infirm and needs assistance.
  1. The patient must wait outside (in their car, or socially distanced from others outside the building) and not in reception area. The RMT will call or text when it’s time to enter. If the patient has not received a call/text message from the RMT 5 minutes past their appointment time please call the clinic at 604-474-2282.
  1. The RMT will greet the patient at the reception area so no one is waiting.
  1. The patient is required to use the automatic hand sanitizer immediately after entering and before departing the clinic. If the patient’s hands are visibly dirty, they will use the washroom to wash their hands prior to using the hand sanitizer. Proper handwashing protocols will be posted at all sinks and reception area.
  1. The RMT and patient will review the steps taken in the pre-screening to ensure that they were completed, to confirm safety and trust moving forward.
  1. The RMT has the right to cancel treatment if the patient doesn’t meet the pre-screening criteria on physical presentation upon arrival at the clinic.
  1. The RMT is required to use a non- contact thermometer to take the patient’s temperature, and may also choose to use the fingertip pulse oximeter to check the patient’s oxygen levels.
  1. The patient must be aware that they are empowered to make decisions regarding their own safety in the treatment environment. The patient can ask that the RMT to wear additional PPE such as, gloves and goggles in order to help the patient feel safe.
  1. For immunocompromised or at-risk patients, 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.
  1. Distancing protocols will continue throughout the clinic –RMT’s and patients will maintain 2 metres / 6 feet of distance in clinic areas other than the treatment room, as best as possible within the clinic.

TREATMENT ROOM/HYGENE

  1. It is not possible to maintain physical distancing in the treatment room so pre-screening, physical distancing, hand hygiene, and enhanced cleaning help reduce the risk of transmission, and enable the RMT to practice while minimizing risk of harm.
  1. The patient is required to wear a mask during the whole visit to the clinic, the only exception can be made is if the patient is face down and the mask is making them feel claustrophobic.
  1. RMT’s will continue to wash hands often, using soap and water for a minimum of 20 seconds each time before and after treatment, before and after disinfecting spaces, before donning gloves and after taking gloves off, and before donning or doffing other PPE like facemasks or shields. The RMT may also use sanitizer throughout treatment.
  1. We will sanitize the treatment table, table adjustment levers and face cradle as well as equipment and supplies (table levers, lotion bottles, etc.) immediately after each patient.
  1. Masks are required and available for patient’s upon request.
  1. RMT’s will be wearing masks and at times other PPE.
  1. Patients are asked to try and avoid touching their face; coronavirus can be spread by touch if a person has used their hand/s to cover a cough or a sneeze.
  1. Patient’s must ask the RMT for a tissue if an itch must be addressed or if they have to sneeze or cough. RMT’s will use a hand towel or tissue to touch or scratch their face, or to sneeze into.
  1. Tissues are available in the reception area, treatment room, and washroom.
  1. The RMT will open and close the door before, during, and after treatment as required, using a hand towel/sanitized barrier as needed, and washing hands as appropriate. Patients are not to touch door handles. At the end of treatment, the RMT will leave the room for the patient to get dressed. Patients will stay in the room until the RMT knocks to ensure the patient is ready to leave the room. The RMT will open the door for the patient to proceed to the reception area.
  1. During the time of payment if any payment is under $100 please use tap feature. All receipts will be e-mailed to patients and cash is not permitted at this time.
  1. The patient will be accompanied by the RMT to the exit and they will open the door for the patient using a hand towel or other sanitized barrier.
  1. Avoid socializing in person in the clinic.
  1. The patient cannot book a massage appointment that exceed 60 minutes until further notice.

ENHANCED CLEANING/SAFETY

  1. We will clean and disinfect all high-touch surfaces in between patients, regardless of appearance. A Cleaning and Disinfectant for Clinic Setting Poster will be on display in the reception area, patient restroom and treatment room.
  1. We will frequently clean and disinfect common areas and high touch surfaces, at least twice a day, e.g. light switches, window coverings, cell phones, tablets, chairs, stools, table surfaces, and washrooms.
  1. We will frequently clean and disinfect handles: doors, cabinets, faucets, fridge, microwave, etc. electronic device keyboards and mice, phones, arm rests of chairs, desk and table surfaces, sanitize POS machine.
  1. Linens will continue to be washed in hot soapy water after each use
  1. Automatic paper towel dispensers have been installed.
  1. HEPA air purifiers have been put in each treatment room as well as reception and staff room areas.
  1. The use of thermophores will no longer be used. If a therapist uses a blanket it will be washed/dried in high heat between each patient.
  1. All clutter, fabric furnishings and decorations that cannot be sanitized after touch have been removed.
  1. Appointments have been staggered to reduce traffic.
  1. Floor decals have been installed to help patients stay 2 feet/ 6 meters apart.
  1. Sneeze guards have been installed in reception area.
  1. Corner mirrors have been installed to ensure that no one unintentionally crosses paths.
  1. Sanitary waterproof protective fitted table covers have been purchased for proper disinfecting protocols

PROFESSIONAL OBLIGATIONS

  1. The RMT must call Public Health at 8-1-1 if any patient alleges that they contracted COVID-19 from the RMT.
  1. The RMT must then cease practice and self-isolate until Public Health has investigated and provided direction.
  1. 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 risks
  • The RMT will document the patient’s consent.