Reopening: Considerations for Your Rehab Clinic in a Post Covid-19 World
By: Jennifer Heiligman, PT, MPT
Although the pandemic is not yet over, the world is slowly starting to reopen. It feels like we are awakening from a few months of hibernation to find a whole new world. Whether you are getting ready to reopen your clinic or you were fortunate enough to have kept it open in some capacity during the pandemic, there are many items to consider in this post Covid-19 environment. These include such things as the readiness of your state and local community, the preparedness of your practice and whether or not patients are ready and willing to return to your clinic.
As a business establishment, you should stay informed regarding your local government regulations related to the pandemic. Are you allowed to start seeing patients in person? Are there restrictions on the percentage of capacity based on the size of your clinic space? It may be best to contact your Chamber of Commerce to verify local requirements. Each facility also needs to consider the risks associated with reopening. This includes the safety of your patients and staff, and the fact that you don’t want to contribute to the additional spread of the coronavirus within your community. The Centers for Disease Control (CDC) has a whole page dedicated to information regarding Covid-19: click here. The AMA has also provided a physician guide to reopening which contains great information that is also relevant to rehab therapy professionals. This guide can be found here. Taking all these factors into consideration and completing a cost-benefit analysis for your own clinic should help you determine the feasibility of reopening.
Once you have made the decision to reopen, considerations now need to be made regarding the details of how to safely administer therapy. The Centers for Medicare and Medicaid Services (CMS) has issued a guide for reopening non emergent healthcare: Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare. The APTA has also released a great resource: Considerations for Outpatient Clinics During COVID-19.
One of your first considerations should be physical distancing. Equipment, tables and patients should be kept at least 6 feet away from each other. This may require you to reconfigure your clinic. You may also want to install physical barriers, such as plexiglass dividers, between your front office staff and patients. Don’t forget the waiting room. You may wish to eliminate this space altogether. Consider having your patients text your office when they arrive and wait in their cars until you are ready to see them. If you do keep a waiting room, consider getting rid of any fabric furniture and having only furniture that can easily be wiped down and cleaned and remove any high touch items such as magazines. Installation of hand sanitizing stations is also a good idea. For your staff, individual work stations could be created to help reduce cross contamination and break rooms may need to be reconfigured with a limit on the number of people allowed in at one time depending on the size of the room.
The sanitation of your clinic is imperative. Cleaning and disinfecting all equipment and surfaces should occur after each patient and on a regular basis. You may wish to limit restroom usage to emergency use only with required cleaning after each use. Use disposable paper towels and touchless trash cans. You will want to put procedures in place based on your state and CDC guidelines and clearly communicate these procedures to your staff and your patients to make them feel more comfortable. Posting these guidelines on your website, in addition to, posting them at your clinic is suggested.
Now that your physical spaces are clean, you need to make sure your humans remain safe and clean, as well. Be sure to have enough PPE available for all staff prior to opening. All staff should wear a mask and other PPE as indicated by OSHA regulations. (Guidance on Preparing Workplaces for COVID-19) This could include gloves, face shields, goggles and disposable gowns. It is also recommended that patients wear face coverings as well.
Are your patients ready and willing to resume in person therapy? The best way to increase the percentage of patients that feel comfortable resuming in person therapy is to instill confidence in the patients that your practice is doing everything they can to keep them safe. Communication will be key. Be sure to communicate to your patients in advance your new policies and procedures that have been established to maintain safety for them and your staff. Posting the guidelines on your website and other social platforms is one way to share the information. If you use OptimisPT you can send this information through your EMR via customized email templates as well as the mass email feature.
The new policies may include having them wait in their car until you are ready to treat them and to restrict companions unless absolutely necessary. Offer touchless payment, when possible. You may have to adjust patient appointments and clinic hours to be able to decrease the number of people in the clinic at one time. When they do arrive, they may be screened to determine if it is safe for them to participate in therapy. This screening may include taking their temperature, assessing if they are suffering from any Covid-19 related symptoms and answering additional questions regarding any possible exposure to the coronavirus. It is recommended that your practice create a script for those instances when you have to turn a patient away. If your practice is able to provide telehealth, be sure to offer that service as an alternative to those most at risk patients and those who continue to be hesitant about going into public places. The more informed your patients are, the more apt they will be to return to the clinic.
We are entering into a new normal that will change the appearance of rehab therapy forever. There will be challenges, but you should try to be as flexible and open to changing how your business functions as possible. This new environment may even present new opportunities. Therapists are problem solvers by nature. We got this! Take advantage of the many resources available including information from the CDC, CMS, and professional organizations such as the AOTA, APTA, and ASHA. By educating yourself, your staff and your patients, you can set your clinic up for success in the post Covid-19 landscape.