We are here for you: Urgent Patient Management and Video Physio in Full Swing April 13, 2020

Hello and best wishes following this Easter weekend,

As the Alberta Pandemic Response continues, we are proud to be playing a positive role in it as well. Since the launch of our Telehealth program, AKA Video Physio, hundreds of patients have benefited from the expertise of our team. This has included people who are under quarantine to those who continue to play their own part by staying home but still need to manage pain and injury. The success of our program has been remarkable and rewarding.

Our urgent patient model continues to see those most in need. This includes those people who have no alternative and in which Telehealth care won’t keep them on the front lines or out of emergency departments. This has brought out the very best in all of us. We know that we can make a huge difference and we are doing our best to keep front line workers doing what we all need them doing and to keep the burden off of the medical system so that they too can focus on what we all need them to be focused on.

Some examples of our urgent patient model over the last few weeks included a front line nurse who had such severe headaches she was having difficulty managing at work. A grocery store worker who’s back pain radiating into her foot was leaving her with little choice except an emergency department. Not only have we kept her from the ER, we have been able to keep her at work. In almost all cases to date, we have been able to achieve our goal: to keep people out of hospitals and able to function as essential service workers. They need us, but more important, we all need them.

overview of our current practice environment:

The Chief Medical Officer’s directive specifically states that urgent and emergency patients can still be seen at the discretion of the professional who is providing the service. Our College and Association has since provided further guidance on this matter. Click here for Physiotherapy Alberta College and Association statement.  We are strictly adhering to the directive and the guidance of our professional regulator.

please remember why remain open to urgent and emergency patients?

We continue to weigh our ethical and moral obligations with the risks that are associated with those obligations. Our team has come together and wishes to continue to play a positive role in the response to the pandemic environment we are all facing. We believe that within the definitions of our urgent patient screening process, there is a population of patients who need to be seen in a facility to keep them from emergency rooms, to assess and triage post surgical patients with no other alternative forms of care and to help to manage front line medical / emergency personnel who might not be able to continue to work without our services.

We are committed to giving care to patients who can be seen appropriately via videoconference and telemedicine. When appropriate, this is our preferred method of treatment in today’s environment.

This is not a decision that we are making based on employment or incomes. We remain open in order to provide a needed service to a very specific population based on our commitment to being a part of the solution. Keeping the wheels of the healthcare system moving continues to be of paramount importance at this time.

our urgent patient screening remains the same at this time:

• patients should have had the opportunity to perform a self screening process (will be referred to our website to identify whether they meet our criteria as an urgent patient).
• patients who contact our facility via telephone or email will be additionally screened for the urgency of their care.
• upon identification of the need to urgent/critical care by a patient and confirmed by our administrative assistants, a follow up telephone call will be received from the on duty therapist.
• the physiotherapist has the ability to make the final decision regarding who may attend as an urgent patient.
• our screening process will assist with identifying whether an initial consult may be appropriate for our telerehab program, to ensure only those patients who are urgent are attending our facilities and to recognize those patients who may have symptoms of illness in order to assist with the triage process and maintain the integrity of our infection control policies and
• only patients who remain urgent and have no alternative means of treatment will be seen further in person in our facilities.

are you an urgent patient (3 steps)

Step 1 – In order to ensure compliance with our own screening process, we ask you to first identify yourself by the following criteria. Step 2 – this will be confirmed by our administrative assistant and Step 3 – again by a physiotherapist:

Physiotherapy services in private practice or ambulatory care settings are only considered urgent if:

• Services cannot be provided using an alternate form of delivery, such as telerehabilitation.

AND

• In the absence of physiotherapy services, the patient will require health-care services in an emergency department setting (e.g., severe pain requiring physician intervention or prescription medication to manage that pain).
• The patient is an essential service provider (e.g., health care provider, first responder) who is unable to work  due to an acute injury or exacerbation or a pre-existing condition, whether that injury is WCB compensable or not.
• The patient is seeking services related to a recent surgery or removal of a cast/immobilizer.
• In the absence of physiotherapy services, the patient’s functional status will deteriorate to the point of requiring invasive management or hospitalization in the foreseeable future.

(source – Physiotherapy Alberta College + Association)

covid 19 self pre-screening

I would like to be crystal clear: we ask that you do not attend the Clinic if the following applies to your situation:

• You have been or suspect you have been exposed to COVID-19;
• You have returned from travel outside of Canada after March 10, 2020;
• You or anyone in your close social circle are ill (any signs of illness including sore throat, cold or allergies);
• You are immuno-suppressed;
• There has been evidence that COVID-19 is more severe in people over age 65.  If you are over age 65, please consider if in clinic treatment is CRITICAL to your health currently.

your urgent appointment is important – these are steps we are taking

• enhanced screening including day before and day of confirmation that patients are not presenting symptoms, haven’t recently travelled and are not caring for anyone who is ill,
• all staff are facing an enhanced screening process daily and have voluntarily agreed to be self isolating during the pandemic,
• all patients are required to wash hands upon entry to our facilities,
• less clinical beds, staff and no crossover of our professional staff to increase physical distances in all of our clinics,
• no paper or pens (all forms are electronic filled in advance and all consent will be verbal),
• waiting rooms will be eliminated
• patients are asked to wait in their car until their appointment,
• patients will be chaperoned to ensure hand washing and identity points of contact while entering our facility,
• shortened appointment times with minimal support staff (critical support staff for infection control),
• ongoing advanced infection control and sterilization procedures including immediate disinfection of all contact points in our facilities,
• signs that ask patients to respect the 2 meter distance between one another,
• our staff will be wearing gloves, (cloth masks and protective eye-wear will be added when available) – it is important to note that these are not the same masks that front line covid response workers require to remain safe themselves. We are taking this step to remind ourselves not to touch our faces. By having these barriers, we can ensure that we are not exposing ourselves to contact related viral transmission, and
• if you are unable to abide by the above requirements we will be unable to provide urgent care services to you.

Thank you for understanding our role as primary healthcare providers in Alberta. We continue to be here for you, whether on the phone, over video-conference or in person if appropriate. We appreciate the amazing support from the community and our staff. Your messages of support have lifted us all up and continues to energize us.

If you have any questions, please contact us via email. I am happy to answer your questions personally.

Once again, with deep gratitude to all of you and with all the love in my heart,

Grant Fedoruk