COVID-19 SAFETY PLAN

WORKPLACE RISK ASSESSMENT FOR EMPLOYEES, PRACTITIONERS and PATIENTS

The virus that causes Covid-19 spreads by droplets when a person coughs or sneezes. It can also spread if you touch a contaminated surface and then touch your face and mucous membranes. The risk of person to person transmission increases the closer you are, the more time you spend with 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 a short period of time.

A. Dr. Fred Meinzer is the new Health and Safety person for the clinic.

B. Risk areas are:

- Reception counter

- Hallways where we walk by each other.

- Staff room and storage area where we would gather.

- Individual treatment rooms.

C. Close spaces in office include reception, hallways, staff and storage areas and treatment rooms.

D. Shared items: reception area, stool, pens, tape, post it notes, stapler, phone, mouse, keyboard, POS terminal, printer, sink, cups, glasses, cutlery ,condiments, coffee, tea, soap dispenser, dishwasher, hand towels, scrubbers, organics bucket, fridge and dishwasher.

E. Commonly touched surfaces: reception desk, keyboard, mouse, front door handle, kitchen door handle, sink taps, dishwasher panel, fridge door, kitchen cabinet doors and organics bin.

1. Reduce the Risks Identified Above:

We have reviewed the CDC BC and WorkSafe guidelines as well as the BC massage therapy guidelines.
Dr. Fred Meinzer is the health and safety person who has taken input from Staff, Chiropractor and RMTs.
We will follow the guidance of the Provincial Health officer which are:
Social distancing of 6 feet whenever possible.
If unable to social distance then masks are tobe worn by practitioners and staff.
If unable to social distance at the reception desk, a plexiglass barrier is installed.
Notices/posters will be posted, shown below:
At front door – HELP PREVENT THE SPREAD OF COVID-19, STOP NOVEL CORONAVIRUS (COVID-19), STOP AND TAKE THE COVID-19 SCREENING TEST. WorkSafe CLINIC OCCUPANCY 20.
At reception counter – HELP PREVENT THE SPREAD OF COVID-19, SYMPTOMS
OF COVID 19, SOCIAL DISTANCE 6 FEET.
Each treatment room – HELP PREVENT THE SPREAD OF COVID-19.
Kitchen/storage door – STOP AND TAKE THE COVID-19 SCREENING TEST.
Kitchen/storage room
2 PEOPLE IN ROOM DISTANCING.
- 2 PEOPLE IN ROOM DISTANCING.
- THROW ALL MASKS AND GLOVES IN GARBAGE.
- PAPER TOWELS ARE TO BE THROWN INTO GARBAGE.
- HAND WASHING GUIDE/POSTER.
- CORONA VIRUS PREVENTION GUIDE/POSTER.
- CLEANING AND DISINFECTING FOR CLINIC SETTINGS GUIDE/POSTER.
- MASK DONNING AND DOFFING GUIDE/POSTER.
We will follow our Assoc. guidelines.

2. REDUCE THE RISK OF PERSON TO PERSON TRANSMISSION (4 Levels)

To reduce the risk of the Covid-19 virus spreading through droplets in the air, protocols have been implemented for protection against our identified risks. We will try to use the highest level of protection where and when possible.

First Level Of Protection (Highest Level) is to reduce the number of people in the workplace in order to minimize contact and maximize social distancing which is the optimal way to reduce the transmission of the virus.
WorkSafe has posted a maximum occupancy of 16.
We will try to keep 6 feet apart at alltimes.
Practitioners have reduced and spaced out the number of patients/day.
Having only 1 chairs in the waiting room as opposed to 8.
Asking patients to arrive just on time and not early.
If someone is in waiting area then the other patient is asked to wait in hallway area. Taking patients immediately upon arrival into treatment room.
Booking and paying in the treatment rooms as opposed to reception area.
Taking patients immediately upon arrival into a treatment room.
Having only two people in the kitchen/storage room at a time.
Waiting for hallways to be clear before entering them.
Not allowing visitors into office unless someone needs a caregiver or a guardian.
Second Level Of Protection is to have physical barriers to stop the virus transmission. We have installed a plexiglass barrier at our reception counter for staff who has to engage with patients within 6 feet.
Barrier cleaning is part of the regular office cleaning policy.
Third Level Of Protection is to create policies and procedures for everyone entering the office; staff, practitioners, and patients. Our new office policies:
Everyone entering the office will be pre-screened for Covid-19 with a Covid-19 screening questionnaire. See APPENDIX A.
Practitioners and staff will self-pre- screen for Covid-19 and keep a log of their results at the office. See APPENDIX B.
Practicing social distancing when and wherever possible.
All practitioners and staff will be wearing masks. See APPENDIX E.
Symptomatic patients, staff or practitioners must not enter the office.
All patients are recommended to bring and wear their own masks.
Masks will be made available in the office.
Hand sanitizer will be available in the office and used upon arrival and exit.
Disinfecting treatment rooms after every appointment.
Regular daily deep cleaning of the entire office. See APPENDIX C.
Limited number of appointments each day.
Reduced waiting area seating.
Asking patients to wait in their car, outside building or in our building’s larger lobby area and arrive just in time for their appointment.
Restricting only those with appointments to enter the office with the exception of caregivers and adults accompanying minors.
Scanning hallway before proceeding to use hallway.
Plexiglass shielding has been installed at the reception counter.
Doing all booking and billing in each treatment room M-F.
Contactless payment with emailed receipts.
Leaving the entrance door open during all office hours.
Opening and closing treatment doors for patients.
Eating in your treatment room and not in kitchen.
In order to help facilitate the policies we have cleaned the entire office of unnecessary things that are not needed to practice. There are no chairs, cushions or pillows that are fabric in the waiting area or treatment rooms. All tables and chairs and desk tops are surfaces that are easily cleaned. The iMac keyboards are covered so as to allow cleaning. The kitchen counters are cleared and only minimal cleanable items are left on it. All unnecessary patient chairs are taken to the storage room.
We have posted the recommended products for the office from the CDC and health Canada guidelines, those being accelerated hydrogen peroxide 0.25%, bleach 5.25% 1:100 solution, 70% isopropyl, hand sanitizer, alkyl dimethyl ammonium chlorides and benzalkonium chloride. See APPENDIX D. We will keep a 2 weeks supply of soap, paper towels, hand sanitizer, cleaning and disinfecting solutions and non-surgical masks.
We have eliminated all cloth hand towels for washing or cleaning and installed a paper towel pull dispenser at the sink.
RECEPTION – clean waiting chairs, reception counter, POS terminal, coffee tables,
plexiglass, desk, mouse, keyboard, phone, stool, scanner and printer 3x/day.
KITCHEN/STORAGE – clean door handle, counters, microwave door/handle, fridge door/handle and dishwasher door panel 3x/day.
TREATMENT ROOM 1 – clean treatment table, patient chair, patient end table, instruments used on patient such as laser head, laser goggles, adjusting instruments, blood pressure cuff and scope, reflex hammer and any other surface the patient touches after each patient. As well, the office desk, keyboard, phone, stool, shelving surfaces and door handles are all cleaned 2x/day (practitioner opens and closes the door for patients).
TREATMENT ROOM 2 – clean treatment table, patient chair, instruments used on patients such as adjusting instrument, blood pressure cuff and scope, reflex hammer, POS terminal and any other surface the patient touches after each session. As well, the office desk, keyboard, phone, stool, shelving surfaces and door handles are all cleaned 2x/day (practitioner opens and closes the door for patients).
TREATMENT ROOM 3 – clean treatment table, patient chair, any instrument used and any other surface the patient touches after each patient. As well, the office desk, keyboard, phone, stool, shelving surfaces and door handles are all cleaned 2x/day (practitioner opens and closes the door for patients).
TREATMENT ROOM 4 – clean treatment table, patient chair, any instrument or tool used and any other surface the patient touches after each patient. As well, the office desk, phone, fireplace counter, stool, and door handles are all cleaned 2x/day (practitioner opens and closes the door for patients).
TREATMENT ROOM 5 – clean treatment table, patient chair, any instrument or tool used and any surface the patient touches after each patient. As well, the office desk, stool and door handle are all cleaned 2x/day (practitioner opens and closes the door for patients).
TREATMENT ROOM 6 – clean treatment table, patient chair, any instrument or tool used and any surface the patient touches after each patient. As well, the office desk, stool, and door handle are all cleaned 2x/day (practitioner opens and closes the door for patients).
Fourth Level Of Protection is the use of MASKS which has limitations in reducing the spread of Covid-19 and is therefore considered a fourth line of protection. Hence masks should be part of the first three protection levels and not the only measure.
All practitioners and staff will wear disposable masks in the office at all times.
Recommendation to patients to bring and wear masks when in office.
Proper selection and use of masks from WorkSafe BC. See APPENDIX E.
DONNING and DOFFING mask poster are posted in kitchen to show staff and practitioners how to properly use their masks.
Each practitioner is responsible for his/her own PPE.
Each practitioner is responsible to provide their patient with a disposable mask if requested.
The office will store extra masks at reception.

3. REDUCING RISK OF SURFACE TRANSMISSION VIA CLEANING AND HYGIENE

Review cleaning and disinfecting protocols in office. We have the plan above on what to clean in each room, the frequency, as well as the types of cleaning and disinfecting agents which will be supplied for each treatment room, reception and kitchen area.
We have one handwashing station in the office for the current total of 7 practitioners and 1 PT staff.
Handwashing policy for practitioners is that they wash or sanitize their hands upon arriving to the office and in between each patient visit, before and after any meals and when they leave the office.
Handwashing policy for the staff, is that they wash or sanitize their hands upon arriving to the office, after handling anything which has come in contact with someone else, any time before and after they clean the office, before and after any meals as well as when they leave the office.
Hand sanitizing policy for patients and laundry person, is that they hand sanitize at entrance station upon arriving and again upon exiting the office.
We have posted hand cleaning posters at the sink.
Practitioners and staff have been given these policies and training posters.
We have reviewed the office in order to look for any unnecessary items that could be removed in order to simplify the cleaning process such as removing the cloth reception chair with a vinyl covered stool, removal of all magazines, removal of the water cooler, extra chairs, fabric cushions, orthotic samples, lotion bottles, medical equipment, loose tea and coffee, mugs and cups, cutting board, utensils and dish cleaners.
We have a 3x/day cleaning routine of the barrier as well as the general office. Cleaning routine are M/W/F ( Dr. Harold ), Tue/Thur ( Dr. Fred ) and Sat ( Emily ).
Times of cleaning : M/W/F are 9:15 AM, 1:30 PM and 6:30 PM. Tue/Thur are 11 AM, 3 PM and 7 PM. Saturday are 9:30 AM, 12 PM and 3:30 PM.
Created a cleaning log. See APPENDIX C.
Using approved cleaning/disinfecting products. See APPENDIX D.
Each practitioner is responsible for cleaning their own treatment room with the recommended cleaning and disinfecting solutions provided in their rooms.

4. POLICIES TO MANAGE THE OFFICE IN ORDER TO KEEP EVERYONE HEALTHY

(ALL WORKERS MUST SELF – ASSESS FOR COVID-19 DAILY BEFORE COMING TO WORK AND KEEP A DAILY LOG OF THEIR SELF-ASSESSMENT)

Ensure anyone showing any symptoms of Covid-19 are prohibited from entering the office. This is for practitioners, staff, patients, guardians, care aides, laundry service by telling them the policies and having them self-screen for Covid-19 symptoms.
Anyone who has had Covid-19 symptoms in the last 10 days is prohibited from entering the office. These symptoms include fever, chills, runny nose, sniffles, nasal congestion, sore throat, a worsening cough, shortness of breath, new muscle aches or headaches, delirium.
Anyone who has been told to self- isolate by a medical official is prohibited from entering the office.
Anyone who has travelled internationally or who has come in contact with a confirmed Covid-19 person must isolate for 14 days and must not enter the office.
Visitors are prohibited from entering the office unless it is a care aide or guardian.
Violence prevention plan in case patients become violent because they cannot be seen in a timely manner is very unlikely to happen in our workplace. We would call 911.
If a staff member or practitioner begins to feel ill at work they must wash hands and put on their mask and leave the office and go to see their medical doctor or call 811.
If a staff member or practitioner is severely ill and cannot breathe then call 911. Immediately clean and disinfect the area the worker has been in and has touched.

5. OFFICE COMMUNICATION PLAN

We have this Safety Plan guide to give to workers to help train them as to the new office policies and procedures.
All workers have received this Safety Plan guide and understand when to stay home.
All staff and practitioners understand that they must self-assess for Covid-19 prior to coming to work and keep a log of their daily assessments. The daily log will be kept in a binder ( Daily Covid-19 Self-Assessment Log book ) at the reception.
WorkSafe has posted a 16 person maximum in the office at any given time.
e have posted hygiene signage in the office at the front desk, in each treatment room and in the wash area.
We have posted signage at the main entrance indicating who is prohibited from entering the office
ANYONE SHOWING SYMPTOMS OF COVID-19
BEEN IN CONTACT WITH A CONFIRMED COVID-19 PERSON
TRAVELLED INTERNATIONALLY WITHIN THE LAST 14 DAYS.
Workplace monitoring of policies and procedures is done by Dr. Fred and Dr. Harold Meinzer.

6. MONITORING THE OFFICE AND IMPLEMENTING UPDATED POLICIES AND PROCEDURES

We will monitor the office to look for other potential risks of Covid-19 transmission.
We will update this Safety Plan when we identify and add policies and procedures.
Workers know to come to Dr. Fred and Dr. Harold Meinzer with health and safety concerns.

7. RISK ASSESSMENT DUE TO RESTARTING THE OFFICE

Workers will be given this Safety Plan to review and begin training in the new policies and procedures.

APPENDIX

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A COVID screening
B Daily COVID self-assessment and weekly self-assessment log
C Daily cleaning disinfecting log
D CDC BC Cleaning
E Mask Selection
F Treatment room protocol