Preparing your physical office before in-person visits begin

Before you start increasing your in-person visits, here are some thing you can do to make the transition go smoothly.

In general

  • Go paperless. Use virtual forms (no clipboards or pens!) and fax requisitions directly to the receiving entity such as laboratory, pharmacy, or medical imaging, so the patient isn’t given paper.
    • Lifelabs now has a central fax number for the entire province: 1-888-674-0370.
  • Can your staff work effectively from a remote or home location? Does your office support the technology (computer and phone system) to permit this? Can you leverage this opportunity to keep your staff safe? 
  • Create a voicemail message advising patients to check in by phone before presenting for in-person appointments. 
  • Ensure alcohol-based hand sanitizer (with at least 70% alcohol) is available at multiple locations: office entrance, reception counter, waiting room, and by every exam room for use before entering and exiting. Consider automated dispensers affixed to walls wherever possible to reduce handling.
  • Replace cloth-covered furnishings with easy-to-clean furniture where possible. 
  • Provide disposable tissues and no-touch waste receptacles in the waiting area and exam rooms. 
  • Increase air circulation in the clinic wherever possible, preferably with an outdoor air source. 
  • Install automatic doors or keep frequently used doors open to avoid recurrent door handle contamination. 
  • Develop a contingency plan for staff illness and shortages.
  • Consider contactless payment options, such as tap. 

At your entrance/waiting room/reception area

  • Post your COVID-19 safety plan at the entrance and on your website.
  • Create and post signage/posters at entrance doors, reception area, and exam rooms
    • Entrance signage: no entry if unwell or in self-isolation, respiratory etiquette, physical distancing reporting illness or travel history
    • Waiting room signage: physical distancing, respiratory etiquette and occupancy limits.
    • Exam room signage: hand hygiene.
  • Install Plexiglas partitions to separate patients from reception staff. 
  • Rearrange the waiting room to ensure a minimum 2 metre distance between seats. 
  • Provide plain soap and paper towels in patient washrooms and at staff sinks and post hand hygiene posters.
  • Clearly post your visitor policy for vendors, educators, service providers, etc. outside the practice door and on your website.

In common areas

  • Remove all commonly handled items from your waiting room and examination rooms: flyers, brochures, magazines, displays, toys, etc.
  • Rearrange workspaces to provide 2 metres of distance between staff, and consider dedicated workstations and patient rooms so fewer people touch the same equipment.
  • Display PPE donning and doffing instructions in locations available to all health care providers and staff. 

In exam areas

  • Empty exam rooms of all but bare minimum of equipment (e.g. exam table, chair, BP cuff, lights). No magazines, pamphlets, or toys. Move supplies (such as cotton swabs) into drawers or cabinets to facilitate easy wipe-down of surfaces).
  • Provide paper sheeting for exam tables and change between patients. 

On a regular basis

  • Monitor staff wellness and ensure staff with any COVID-19 symptoms are not at work and follow appropriate MHO guidance.
  • Limit non-patient visitors, but for those who must physically enter the practice to do repair work, for example, designate a window of time outside of normal office hours to minimize interactions with patients, clinicians, or staff. 
  • On a weekly basis, determine the amount of supplies needed per patient, and only schedule the number of patients you can safely see. If you don’t have enough PPE, adjust in-patient care accordingly so you don’t run out.
  • Have supplies safely delivered outside the door of your practice, and ensure you sanitize everything before use.
  • Maintain copies of pandemic educational materials and self-care guides for patients (provided by public health). 

Clean and disinfect

  • Post current cleaning policies and guidelines, including a list of approved cleaning products as per Health Canada and the BCCDC, for all office clinical and administrative staff to be aware of.
  • Clean and disinfect:
    • Shared reusable medical equipment (stethoscopes, blood pressure cuffs, etc.) in between patients and at the end of each shift.
    • Exam rooms at least twice a day (chairs, tables, floors). frequently touched surfaces at least twice a day (work stations, cell phones, door knobs, etc.).
    • Front office counter, door handles, waiting room tables and chairs, clip boards on a regular basis.
  • Consider designating a roving “sanitization technician” responsible for constant sanitization of areas of concern.
  • Maintain a minimum 2-week supply of plain soap, paper towels, hand sanitizer, cleaning supplies, and surgical masks, if possible.