TO OUR HEALTH CARE PARTNERS AND OTHERS:

We have remained available to some clients and to new clients during these extreme circumstances based on protocols we have developed.

We have significantly reduced staff and moved almost all consultations to telehealth – however, we have been asked by doctors and health care workers to provide services to those for whom physiotherapy will be essential to their immediate recovery or to those who are essential workers in their own case (paramedics, nurses, etc.) whose absences during this pandemic could be more damaging to the system.

We have asked some staff to volunteer to remain available, and we have established rigid protocols for clients to ensure we can limit our exposure, and theirs, during what is obviously challenging circumstances in health care.

We have been guided by five fundamental principles:

1. Physiotherapy services can be essential in the very early stages of recovery to ensure the long-term damage to a patient is mitigated. While these are challenging times, the long-term risk to clients from NOT helping can violate the commitment to first do no harm.
2. Physiotherapy can be an essential part of treatment for post-operative care, and – during this time – helping patients move from hospital as soon as possible is essential.
3. Physiotherapy can ease the burden on the health care system by keeping patients from choosing emergency room visits if another option is available in urgent situations.
4. Physiotherapy for front-line health care workers – always an important component to any practice – is essential at this time. Health care workers who cannot remain on the job put additional strain on the system by placing extra burden on overworked colleagues.
5. Only essential visits should take place in person – we will do as much as possible to deliver services through telehealth and through other digital options. Those visits that must be delivered will be delivered in the most clinically established protocols possible to protect the patient and the physiotherapist.

We recognize everyone in the health care system has had to make choices about how they provide services to patients during this pandemic, and to be best of our ability, we have limited services to very select patients based on the following criteria:

Protocol & Procedures

“Essential” Physiotherapy Care Definition

Based on our own informed backgrounds; education through governmental sources; other professionals’ definitions throughout Canada; and the severity of risk to not receiving therapy which could impact the client’s overall health and wellbeing, we are abiding by the following guidelines for treatment: 

1. Physiotherapy care/services that have been mandated by a medical doctor or specialist 
2. Conditions that include one or more of the following:

• post-operative care and/or wound cleaning/dressing changes;
• numbness or weakness in the extremities (i.e. neural signs);
• head injuries - including traumatic brain injuries or concussions or debilitating headaches;
• severe debilitating pain or a state that is limiting Activities of Daily Living (ADLs) that the client themselves has deemed essential and/or will avoid an emergency room visit, and
• long term risks to the client if he/she does not receive therapy. This treatment is only offered if the consequences of not receiving treatment are assessed as more severe than the COVID-19 contraction risk by both the physiotherapists AND the client themselves after informed consent and education is provided. 

3. Physiotherapy treatment for any trauma that can be treated within a physiotherapy clinic to move the visit from a hospital Emergency Room, with the goal of reducing the demand on the medical system and front line workers. 
4. Physiotherapy care/services that are deemed essential to keep an Essential Worker at work and a contributing member of the health care team during the fight against COVID-19, provided only if the consequences of not receiving treatment are assessed as more severe than the COVID-19 contraction risk by both the physiotherapist AND the client themselves. 

Our Increased Protocols & Procedures during these times for clients deemed Essential

1. Informed consent with increased attention regarding risks and benefits of therapy during COVID-19 times (obtained over the phone and in person if they are deemed essential)
2. Informed consent in regards of our definition of Essential Care
3. Protocol for entry:

• temperature taken upon entry as well as hand washing for all (both clients and employees)
• informed consent reviewed upon every visit
• no contact between two clients at any point in time
• no waiting room
• client is sent straight to room with guiding stickers  (logo and clearly defined direction of traffic) 
• client is entered into a CLOSED room, which has been disinfected twice prior to entry
• no payment is taken unless contact-less 
• proper PPE is utilized

4. Transfer to Telehealth is done as soon as possible, given the opportunity to eliminate in-clinic visits
5. Email of appointments/documentations/exercise programs are given instead of cards 
6. Gym and commercial pool are closed to all clients and are not accessible during these times.                                                                Many other protocols and procedures in regards to normal practice are still included and not exhausted in this list, but these are the most notable at this time. 

This is a living document due to the ever changing rules and regulations. 

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