Infinity Medical Specialists Clinic COVID-19 Reopening Plans

Last updated June 7, 2020 This document is an adaptation of the PHC COVID-19 Ambulatory Reopening Plans. Please note: Amendments to this document will occur as COVID-19 recovery phases evolves. Clinic Visit Policy A) Virtual visits • Virtual visits and telephone-consultation should be prioritized over in- person appointments when appropriate. • All NEW patients will be assessed via virtual visits at this time until further notice. B) In-Person visits • Patient bookings will be limited in order to ensure that patients can follow physical distancing recommendations while accessing services, but should be prioritized by urgency. • Each MD is given a 1/2 day per week to perform in-person visits. • Elective procedures for patients with infectious symptoms should be delayed until the patient is deemed recovered and non-infectious according to the provincial protocols, or the procedure becomes urgent or emergent. Booking Procedure A) Only MDs can request to book in-person visits at this time. B) Book patients at non-overlapping intervals to minimize number of patients entering/exiting the clinic at the same time. **Current set-up allows for at most 2 MDs seeing patients concurrently. Each MD would have 2 exam rooms to use. Patient will be directed to wait in the empty exam room. Overflow patients would wait in our common waiting room area. The waiting room is able to accommodate 2 sets of patients +/-1 partner. C) Only 2 physicians are allowed to schedule in-person appointments at any given time. D) When possible, encourage patients to come to their appointment alone and do not allow extra people in the clinic room (e.g. spouses, children). The exception would be given for a support work and/or a translator. Pre-Visit Screening Clinic staff should contact patients by phone OR by email at time of booking to determine if patients/clients or family members have developed COVID-19 like symptoms, have COVID-19 contact and/or have recent travel history. Please refer to Appendix 1 for COVID-19 screening questionnaire. A) If screening identifies that the patient has COVID-19–like symptoms, the Clinic staff should: • Notify patient that this information will be communicated to the MD and that this appointment will be rescheduled for a later date. Ask patient to call back in 14 days or more. • Send a memo to MD B) If screening does not identify COVID-19 like symptoms, • Patients/clients should be reminded that they will undergo screening assessment again on the day of appointment. • The use of masks is MANDATORY for all patients and clients in the clinic, regardless of COVID-19 status. Reminder Screening The questionnaire will be sent via appointment reminder TEXT and/or EMAIL. A) If screening identifies that the patient has COVID-19–like symptoms: • Patient will be asked to call the clinic and rebook his/her in-person assessment AND be redirected to his/her primary care provider. • MD will be notified via Memo. B) If screening does not identify COVID-19 like symptoms, • Patients/clients should confirm the appointment and refer to the new clinic policies. Onsite Screening At the entrance of the clinic, the clinic staff will conduct an onsite screening. Please refer to Appendix 2 for detail. The questions are posted at the clinic entrance. A) If screening identifies that the patient has COVID-19 –like symptoms, the Clinic staff should: • Communicate to the MD to determine the status of this appointment. • As a general rule, symptomatic patient should not be allowed into the clinic. They should be redirected to their primary care provider, 8-1-1 and/or local acute care centre such as the Urgent Primary Care Centre/ UPCC. B) If screening does not identify COVID-19 like symptoms, the clinic staff will perform a temperature check in the hallway. Patients are only allowed into the clinic, if their temperature reads less than 37.6 degree. • Patients should perform hand hygiene (via hand sanitizer) upon entry to the clinic. • Ensure patients remove gloves and perform hand hygiene. Gloves should not be put back on. • Check patient into clinic with non-contact viewing of their health care card. • Ask patient/client to wait in the exam room assigned to their MD. During clinic stay • Staff is to follow the Point of Care Risk Assessment to determine appropriate PPE requirements. • Throughout the visit, remind patients to: Practice respiratory etiquette, such as coughing and sneezing into the elbow, avoiding touching the face, mouth, nose, eyes and, mask Perform hand hygiene. Maintain physical distancing. After clinic visit • Patients/clients should perform hand hygiene before leaving the clinic • Follow-up appointments will be made via telephone. • Exit through the back clinic door ONLY, obeying one-way traffic flow newly implemented in the clinic. Clinic Policy regarding Family/Visitors/Support • To reduce risks of COVID-19 for patients, clients, family and staff, no visitors are permitted for appointments. • If the patient/client requires support to attend, this is to be restricted to one person. They will need to wear their own mask. • Support persons who present with COVID-19 like visible symptoms will not be permitted to enter the clinic for the safety of patients and staff. Clinic Policy regarding Staff/MedicalStaff • Staff/Medical staff must follow the PPE Recommendations – Acute. • Staff/Medical staff should be encouraged to clean and disinfect their own work space following the IPAC Guidelines. • At IMSC, all high touch areas will be cleaned every 2 hours, if there is patient traffic. Clinic Policy regarding patients of high risk/COVID-19 like symptoms • IMSC is not equipped to care for patients with COVID-19. Anyone identified to have symptoms suggestive of COVID-19 will not be granted admittance to the clinic space. • These patients should be re-directed to their primary care provider and/or Urgent Primary Care Centre and/or COVID assessment site and/or 8-1-1. • If there is a significant concern that the patient is high risk for COVID-19, and there was evidence of gross contamination of the environment by the patient (for example unrestricted coughing and sneezing), the contaminated areas should be closed until terminal clean can be performed. • MD of the symptomatic patient should be contacted right away.   Clinic Policy regarding cleaning and disinfection • For patients with no COVID-19-like symptoms, Staff/Medical Staff should follow routine practices for cleaning and disinfection between patients. • Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distance. • Staff/Medical staff must avoid sharing food and snacks. Equipment/Supplies/Environment Related Policies A) Cleaning clinical areas. During the examination, any medical/clinic equipment used (e.g. blood pressure cuffs, stethoscope…etc) should be cleaned and disinfected by the user following the routine department practices for cleaning and disinfecting. Common areas and high-touch surface areas should be cleaned and disinfected regularly BY THE USERS OF THE AREA, with a focus on high touch points such as reception counters, seating areas (including clinic room seats and armrests), light switches, door handles, taps, phones, keyboards, and counter tops. For cleaning instructions, disinfecting and frequency of equipment, refer to the Infection Prevention and Control Master Equipment Cleaning and Disinfection Manual. B) Cleaning non-clinical areas Other areas such as lunch rooms, should be decluttered, cleaned and disinfected on a daily basis and as needed by those using the space. C) Layout and flow • Hand hygiene stations should be available at both entrance and exit and be easily accessible. • Seating in staff shared spaces, waiting rooms, should be spaced/ taped off to maintain two meters separation. • Non-essential items (remote control, magazines, brochures, etc.) should be removed from waiting areas. • Alternative solutions for the waiting room should be considered. These solutions may include text messaging, while patients wait in their car. • Reception area and clinic hallways should have visual cues to assist in physical distancing (two meters) and one-way traffic flow. Appendix 1 and Appendix 2 see below