In-person services at Eastwood Psychologists during the coronavirus pandemic

On May 26, 2020, the Ministry of Health amended Directive #2 to support the gradual restart of all deferred and non-essential and elective services carried out by Health Care Providers.  This includes the work of psychologists, who are regulated health professionals. For Directive # 2 http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/directives/RHPA_professionals.pdf

At Eastwood Psychologists, we are gradually resuming in-person services where indicated .  We are following the Ministry of Health’s Covid-19 Operational Requirements: Health Sector Restart document, also published on May 26, 2020. For COVID-19 Operational Requirements: Health Sector Restart: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/operational_requirements_health_sector.pdf

Specifically, we are applying a hierarchy of hazard control methods, as recommended by the government.

1.         Elimination and Substitution

The most effective way to contain health hazards is to eliminate in-person health care visits, and substitute them with telehealth.  By offering services virtually, we are able to prevent possible exposure to the coronavirus.   We continue to recommend that clients see their psychologist virtually wherever possible, to ensure everyone’s safety.  Research to date (with adolescents and adults) suggests that virtual therapy is just as effective as in-person therapy.  Thus we expect that it will make sense to continue to offer telehealth services to most of our clients.  For more information about virtual therapy, please see Dr. Naomi Carpenter’s blog post. At Eastwood Psychologists we have two general options for clients to participate in telehealth.

From your home:    This option works well when you have a private space in your home where you can go to meet with your psychologist.  This option also works best when you have a strong Internet connection, particularly when you want to meet with your psychologist using videoconferencing.  Meeting with your psychologist from your home is often more convenient, because it eliminates the need to travel to our office.

From our office:      Now that we have begun to re-open our physical office, you have the option to use one of our offices in order to meet with your psychologist virtually.  Your psychologist will join you virtually from their remote office.  This option works well when you have few options for a private meeting space in your home.

Although we continue to recommend virtual therapy wherever possible, there are some circumstances where virtual therapy is not advisable, possible, practical, or effective.  Before deciding to see a client in-person, we will discuss the need for in-person services and whether it makes sense to proceed.  For clients who will be attending sessions in-person, the following health hazard control measures will apply.

2.         Engineering and Systems Control Measures

These include the use of equipment/barriers to keep people apart and to increase ventilation, in order to reduce opportunities for transmission.  At Eastwood Psychologists, we have installed plexiglass screens that physically separate clinicians and staff from clients.  When the weather allows, windows will be opened to increase ventilation.  When the windows are closed, we will run HEPA filters to assist in removing potential pathogens from the air.

3.         Administrative Control Measures

These measures include the implementation of policies, procedures, training and education with respect to infection prevention and control.    Our policies include the following (subject to regular review and revision as needed):

Education and training:

  • Informed consent process for clients.
  • Passive screening (i.e. signs posted) reminding everyone of symptoms to watch out for and where to get help.

Screening:

  • Active screening when appointments are booked and the day before the appointment.
  • Clients and clinicians must be symptom free in order to proceed with in-person sessions.

Physical Distancing:

  • All staff, clinicians and clients will wear masks at all times while at the office.
  • The waiting room will not be used.
  • Clients will wait outside (on the porch or in their vehicle) until they are cued to come in for their appointment (via text message).
  • Client appointments will be scheduled such there will be at least 15 minutes between sessions to minimize the overlap of clients coming to the office.
  • When appropriate, individuals accompanying clients but not participating in the session, such as those providing transportation, will be asked to wait elsewhere and return to meet the client after the appointment.
  • Office rooms are furnished to allow physical distancing between clinicians and clients.
  • Our office manager will continue to work from home most of the time, but she is able to assist as needed via phone.

Sanitation:

  • All staff/clinicians and clients will wash hands upon arrival at the office.
  • Staff/clinicians wash hands after every client interaction.
  • Signage throughout the office will direct clients regarding where to go and how/when to sanitize their hands.
  • Common areas and other high-touch surfaces and objects handled by clients/patients (e.g., reception counters, chairs and seating areas, door handles, handrails, credit card machines, washroom fixtures, etc.) will be cleaned and disinfected after each use with a hard surface area cleaner approved by Health Canada.
  • Assessment materials or other equipment or items handled by multiple clients/patients will be cleaned and disinfected after each use as above.
  • Sufficient supplies will be available for proper hand hygiene, including hand sanitizer, soap, warm running water and paper towels. Non-touch, lined waste disposal receptacles for use by both staff and clients are provided throughout the office.

An important note about your privacy:

Your privacy is important to us.  It is important for you to be informed that we may be required to share some information about you with public health.  We will be keeping a daily log of everyone coming to the office, staff and visitors alike, in order to provide contact tracing should a case of COVID-19 be associated with our office.   The log will include arrival and departure times of each individual.  The log will be shared with public health if needed/requested.