What Reopening Safely Looks Like: Complying with the Best Practices, Policies and Guidelines

This article about compliance guidelines for reopening was written by Brian Gallagher, MEG Business Management

The COVID 19 pandemic impacting the  world is utterly unprecedented, and has been described as a once in a lifetime event. This means, unfortunately, that nearly everyone – but especially business owners – are feeling the effects.

Right now, the consensus from physical therapy practice owners is that beyond the obvious PPP fund management, they also have to deal with a paradigm shift they are forced to address with their staff. This doesn’t only apply to the clinical side of the practice. The non-clinical side is impacted, too. Owners have all devoted their time, energy and efforts into becoming the best they can be within the outpatient Physical Therapy setting as it was.

The only issue? This was pre-pandemic.

How Practice Owners Complied (and Improved) Pre-pandemic

There were many areas of focus for practice owners before COVID-19 became an issue. These include:

• Education
• Neuro, manual and orthopedic skills
• Equipment
• Space
• Staff utilization

Each of these aspects were all laid out by design. This design? To function efficiently under the Pre-pandemic model of best practices for physical therapy clinic owners and operators.

Post Pandemic Changes for Compliance

Maintaining a viable private practice is going to require a new model post-pandemic. This will involve varying degrees of modifications in order to meet the satisfaction of both the staff and the patients.

Making these changes is key, but making them properly is even more essential.

The best way to ensure that these changes are necessary – and the right choice – is to listen and carefully observe current owners while studying the data that our industry and others have been releasing. This information concerns the “new tomorrow”. Physical therapy community experts come to one very important conclusion. What might that be?

It’s not going to be a one-size-fits-all approach that will be successful for every clinic in question.

Now is not the time to have a dominant “need to be right” attitude. Instead, owners should try harder to better appreciate the fears, sensitivities and ultimately understand the “reality” of others. Physical therapy entails treating and improving the lives of patients with different stories and needs, and the approach taken to do so will need to vary, too.

For this exact reason, it is vital now more than ever that each owner takes full responsibility for two different groups of people. Both practice staff members and the patients entering practices should know and feel confident that their safety and well being has been considered.

How to Ensure that Reopening Safely Procedures are Followed

The first step is to establish procedures and processes that are in accordance with the CDC guidelines for healthcare practitioners. Examples of these are found on their website. Each practice and owner will likely want and need to take different steps to ensure they make the best decisions. However, this is a great place to start.

The following list of documents are a few example PDF files from the CDC. Though different, each one is full of useful information about a different aspect of reopening safely in the wake of the COVID-19 pandemic.

Not only useful on their own, these documents being widely used will ensure that clinics in different locations are following the same basic principles.

1. Get Your Clinic Ready for Coronavirus Disease 2019 (COVID-19)

2. Important Information About Your Cloth Face Coverings

3. Coronavirus disease 2019 (COVID-19) Factsheet:

 

Reopening Safely: The 4 Keys to Business Success

Each of the following topics is essential to mitigating operational risks as clinics and practices begin reopening safely and re-engineer settings to meet the requirements for best practices:

1. ENVIRONMENT
2. STRUCTURE
3. SYSTEMS OF OPERATION
4. PERSONNEL

(For the purposes of this blog we are going to focus exclusively on the physical environment)

ENVIRONMENT: As a result of COVID-19, PT owners need to consider re-engineering their physical environment. The focus needs to be on not only meeting social distancing guidelines, but also ensuring that all hygiene practices are followed. Owners owe it to their patients and staff to alleviate as many of their concerns as possible. Good policies and effective, ongoing communication will help accomplish this.

Physical Environment POLICIES:

• Ensure social distancing of no less than 6 feet between people by minimizing visitor and patient capacity.
• The total number of patients allowed in the office on an hourly basis is determined by the office Director/Manager and approved by the CEO/Owner.
• All physically able caregivers should be asked to wait outside the office or in their cars while their loved ones are being treated. Make it known that the waiting room will be for limited use only, and that chairs will be spaced out accordingly for use when necessary.
• Digitize your front door to limit the amount of facetime required for patients and staff in your waiting room. Use technology services like BetterPT for online scheduling, digital intake forms, and text message/SMS communication. This limits the amount of face time required for patients and staff in your waiting room.
• Consider installing physical barriers (such as clear plastic sneeze guards) at the front desk. This is also useful for other high traffic areas where patients may come into contact with employees.
• Consider offering “senior hours” for your older or at-risk patients to make sure they feel comfortable and safe coming to your clinic.

Owners MUST have a procedure of testing and managing the discovery of symptomatic employees.

This will prevent them from coming to work and potentially contaminating the environment. Many owners are already following the CDC guidelines of temperature checks on a daily basis for their staff to ensure reopening safely. Utilizing 100.4 F as their guideline for determining symptomatic versus asymptomatic is a good place to start.

• Make All PPE supplies available to both patients and staff when appropriate.
• The front desk staff should wear masks and gloves when necessary. Providing facial tissues throughout the office for patient use is another suggestion.
• Have the front desk contact all patients and do some “filtering” of the schedule to remove the most vulnerable ones. This protects them from unneeded risk. If they cannot be rescheduled, telehealth is a safe option for recommendation.
• Have hand sanitizer in every room in the office to encourage hand cleanliness. This is in accordance with the below Hand Sanitizer Use protocol.

Hand Sanitizer Use For Reopening Safely:

• • Apply the gel product to the palm of one hand (read the label to learn the correct amount for application).
  • Rub the gel over all the surfaces of your hands and fingers for 20 seconds. Continue rubbing your hands together until your hands are dry.
  • Alcohol-based hand sanitizers need to contain at least 60% alcohol.
• Post handwashing procedures stating that proper hand washing requires 20 seconds or more of rinsing. These need to be visible at every water source in the office.
• New office cleaning routines should occur, too. These promote a healthier environment that can greatly reduce germ contamination:
• All staff should wash their hands upon entering the office, before and after treating each patient, and when leaving for the day.
• All surfaces will be sanitized with an approved disinfectant from the resource link (www.epa.gov) before and after each patient enters or leaves a room.
• Air purification systems are highly recommended. – One recommended system is the Minusa2. The Minusa2 ultra quiet Air Purifier by Rabbit Air is currently used by hospitals, in clean rooms and in scientific laboratories. It features a proprietary HEPA filtration system and is more efficient at trapping allergens and particles within the air than other types of similar systems.

How Reopening Safely Reflects on Practices and Their Owners

As people across the world learn more about COVID-19 and the way it impacts people, making changes is necessary. These changes apply to more than the way that people live their lives. In order to truly be effective, these changes should extend to the people who provide services to the population – like physical therapy clinics.

Considered medical professionals and representatives of a much larger community, physical therapists and practice owners need to stay informed and up to date. For an inside look at how MEG Academy is taking control of and developing effective leadership skills relating to COVID-19 practices, click here. These three videos will help you narrow your focus both now and post-pandemic when it comes to opening and operating safely.

The most important idea to keep in mind is that information is constantly changing and growing when it comes to COVID-19 and the best practices for therapists and owners.

While the above resources are current as of today, this may not be the case in the future. Stay informed by checking for updates from the CDC as well as state and professional governing bodies often.

If you want to ensure that your clinic offers access options for your patients including in-clinic, telehealth, and in-home visits as you ramp up reopening safely, take a look at BetterPT. They have a streamlined inbound patient management platform that is HIPAA compliant. It is also efficient, featuring a centralized scheduling process and single point of entry for all three types of appointments.

Brian Gallagher is the president and owner of MEG Business Management. With more than 27 years of rehabilitation experience and nearly 20 years in business, Brian’s focus is on helping others. Specialty areas include physical therapy practice management, executive coaching and restructuring practices to encourage efficient operation. Brian also has extensive speaking experience with regard to marketing and public relations.