We provide this update with a full understanding that the current environment is redefining the meaning of challenging. We applaud the efforts that you and your teams are making to provide safe patient care as this pandemic and the response continue to evolve.
In this time of rapid change and uncertainty, chiropractors should not be reluctant to provide care, even when it may be extremely difficult to follow some components of ACAC’s Standards of Practice around provision of care. The ACAC will always consider the individual circumstances and context if a complaint arises during the COVID-19 pandemic. In an emergency situation, failure to meet standards is not considered unprofessional conduct if a chiropractor can demonstrate they took all reasonable actions in their service to patients.
Here is our update for today:
- Clinics remain open at this time: As announced shortly after 1 p.m. today, the Government of Alberta has declared a state of public health emergency in an effort to slow the spread of COVID-19. Information on what is affected can be found here. The ACAC is following the Government’s direction in this regard. As Government has not moved to restrict or close clinics at this time, clinics remain open to provide patient care. All pandemic precautions around infection prevention and control must be followed.
Some members have questioned if we have an ethical responsibility to close so as not to be a vector for transmission. We are grateful that members are embracing Canada's call for each of us to do our part. Not withstanding, the ACAC has confidence in members' ability and commitment to providing safe care by following protocols. As long as clinics are strictly adhering to infection prevention control measures, incorporating social distancing measures in waiting rooms, and actively pre-screening patients, it is appropriate to continue providing care.
This is a very fluid situation and may change quickly. Please watch for updates and prepare for the possibility of restriction or closure.
- Response to confirmed exposure/possible exposure: Many members have asked what their responsibilities are in responding to a confirmed or possible exposure to COVID-19 via a patient. The current guidelines issued by Alberta Health and AHS do not contemplate the practice environment of clinics for community providers such as chiropractors, physiotherapists, etc. The ACAC has drafted protocols that are currently submitted to public health for review. As soon as we have approval of those protocols we will distribute them to the membership.
- Directive communications: The ACAC has implemented directive communications as part of our response to the rapidly changing environment. The directives are specific to time-sensitive changes to daily practice. We want to be very clear about what is required and the results of not abiding by the directives. As a result, they are very direct to ensure clarity. We do not want members to be put in jeopardy because the ACAC’s communication wasn’t clear. All directives can be found on the our website.
- Rescheduling of practice reviews April – June: To reduce pressure on members and minimize courier traffic for clinical advisors and the ACAC, practice reviews that are currently scheduled between April – June will be rescheduled. We expect this to be done by March 31, and affected members will see the new date reflected in their member profile. Members currently undergoing their practice review should complete the process.
- Economic support: Details are starting to emerge about economic support for business owners and for employees affected by COVID-19. Links to this information are available here. There are still outstanding questions for self-employed people impacted by the pandemic. We are actively seeking this information and will advise members when it is available.
- Providing in-person care during a pandemic: It may be overwhelming to contemplate how to provide in-person, hands-on care in a clinic setting. Following are some suggestions for you to consider:
- Implement pre-screening of patients via telephone as advised by Alberta Health Services and reschedule patients who exhibit symptoms or think they may have exposure.
- Invite patients to wait in their cars for their appointment, with the staff calling the patient on their cell phone when the chiropractor is ready.
- Space out appointment times so there is less overlap between patients in between appointments.
- Space out chairs in your waiting room to facilitate appropriate social distancing.
- In clinics with open practice environments, ensure appropriate space is implemented between patients, such as using every other table depending on the treatment space layout. Clinics may also choose to move to the private room format in combination with the open space layout to allow disinfecting time in between use of tables.
- Ensure you are allowing proper time to disinfect your tables in between patients. If disinfectant is running low, public health has advised using a mixture of one part bleach to nine parts water.
If members have other suggestions on how they are effectively managing patient care in this environment please send them to firstname.lastname@example.org and we will share them with the membership.
Stephen Colbert recently made a joke to which we can relate: “2020 has accomplished something impossible; it has made me long for 2019!” While the situation is currently daunting, it is important to remember that this situation is going to move to the rear-view mirror eventually. Continue to take care of your loved ones, your patients and most importantly yourselves with that goal view in mind.