Since the March 17 and March 20 eNews’ we have fielded additional inquiries regarding the provision of OT services during the COVID-19 pandemic that we feel might be helpful for all registered ACOT members.
Please note: Decisions related to the continued provision of OT services are the responsibility of each regulated member in conjunction with the directives given by Alberta Health and your employer, the agency(ies)/funding sources you have contract(s) with, or yourself as a private practice operator. It is not within ACOT’s mandate or legal authority to direct OTs to continue/discontinue practice during the pandemic. If you notice that other colleges or provinces are issuing directives to their registered members, it could be because of differing level of risk (e.g. Alberta dentists/hygienists/assistants perform numerous aerosolizing procedures each day), differing mandates/focus of practice (e.g. Physiotherapy Alberta is also a professional association and has a greater percentage of registered members running private clinics) or differing provincial/territorial legislation or directives (e.g. legislative oversight of health professionals varies between provinces).
Q – Will ACOT be issuing a directive regarding the discontinuation of non-urgent/non-essential services?
A – Unlike some other provinces (e.g. Ontario), the direction to cease or reduce the provision of health services, other than postponement of elective surgical procedures, has not been received. ACOT is following the guidance of the Government of Alberta and Alberta’s Chief Medical Officer of Health https://www.alberta.ca/coronavirus-info-for-albertans.aspx. The only health services discontinued at this time are elective surgical procedures. No other areas of health service delivery or health facilities have been directed to be stopped or closed at this time. As this could change, we will alert you if there are any changes that relate to OT service delivery.
In the meantime, it is up to your employer, the agency you are contracted by, or yourself as a private practice operator to determine, based on the guidance of Alberta Health, whether and how to proceed with OT service delivery.
To assist in making this determination, we cite below what the College of Occupational Therapists of Ontario has prepared in response to the Government of Ontario’s directive to cease or reduce services. The guiding questions include:
- What are the possible consequences to the client if I do not provide the service?
- If a client does not receive occupational therapy service at this time will they deteriorate and be at risk for hospitalization or further use of the health care system?
- Can I meet some of the client’s needs using alternative means for occupational therapy service, for example, virtual or phone check-in, as a way of bridging service?
- Can I work with my other health system partners and referral sources to identify clients with urgent needs?
- Does my organization have pandemic tools and resources to help me make decisions about service priorities?
We also suggest adding in the question “What are the possible consequences to the client if I do provide the service?”, particularly if you are concerned about your ability to fully protect your clients or staff from inadvertent transmission of the virus.
Q – I have a private practice – can I continue to see my clients in-person (in clinic or client’s home)?
A – You, as a private practice operator, are best situated to determine whether and how to proceed with service delivery.
If you decide to proceed, you will find the recommendations regarding remaining open for business in Alberta Health’s business restrictions. Those businesses that are allowed to continue operations, must adhere to the specified requirements (see the “Help Prevent the Spread” posters – accessed from https://www.alberta.ca/prevent-the-spread.aspx). Additional considerations for in-person and virtual service delivery are included in the responses to the following questions.
Q – I do home visits as part of my practice – what Infection Prevention and Control (IPC) practices should I follow?
A – Many OTs conduct home visits as part of their employment, private practice or, are being asked by employers/contracting agencies to offer home visits as an alternate means of service delivery. If an employer has undertaken a risk assessment and determines that they have the proper procedures in place to proceed/continue with in-person service delivery, they should be providing employees guidance on appropriate IPC practices for the protection of the clients/families they serve.
If you or your employer does not have IPC policies and procedures in place, Alberta Health Services (AHS) has prepared several guidance documents that can be used for reference including: IPC for health professionals working in community-based settings and clinic settings as well as IPC in the use/loan of therapeutic items.
These and more resources can be accessed from the AHS “Information for AHS Staff and Health Professionals” page. There is a wealth of information accessed from this link that may be of use and is open access to all health professionals, not just AHS staff.
To limit the inadvertent spread of COVID-19 between clients and staff or staff and clients it is recommended that you pre-screen clients prior to any in-person visits (home or clinic visits). Unless an in-person visit is deemed by you/your employer as urgent/critical, you should not proceed with a home/clinic visit if your client or anyone in the home has any cold or flu-like symptoms. If the client and everyone they live with are healthy, you should inform them of any risks for exposure and what you are doing to mitigate those risks so they can make an informed decision about whether they want the home/clinic visit to proceed.
Q – If my client wants to use FaceTime is that OK?
A – Further to ACOT’s March 17 & 20 eNews’, it is up to each OT/employer to investigate/confirm that any videoconferencing application used meets the security requirements of the applicable privacy legislation for your practice area (will be either Alberta’s Health Information Act (HIA), the Freedom of Information and Protection of Privacy Act (FOIP), the Personal Information Privacy Act (PIPA) and/or the Personal Information Protection and Electronic Documents Act.
To protect your clients from a possible breach of health information and yourself from litigation, you should receive and document verification from the application developer that it does in fact offer the end-to-end encryption required. Once security is confirmed, you can proceed to use the selected application for service delivery. Please refer to ACOT’s Practice Advisory for additional considerations prior to engaging in a virtual session with a client (e.g. client/guardian consent, confirming with liability insurance provider, etc). U of A’s Faculty of Rehabilitation Medicine and CAOT are also providing education sessions/resources on the use of videoconferencing for OT service delivery.
**While videoconferencing options are being considered, triage or follow-up by telephone is a secure option that can be used immediately for continuity of care.**
Q – I have clients that have moved out of province due to the pandemic – what is required if I want to keep seeing them through remote means?
A – Please check with the OT College for the province/state/country your client(s) resides in to see what their requirements are. Most provinces have a courtesy register but requirements vary. The OT Colleges from across Canada have agreed to look at their registration practices for out of province OTs to ensure continuity of care during the pandemic. If offering service using a videoconferencing application, it is up to you to ensure that it meets the privacy/security requirements of the province/state/country your client resides as well as Alberta.
Q – I am on ACOT’s Emergency Roster – when can I expect to be called upon to assist and what might I be asked to do?
A – The response to the Emergency Roster has been amazing! Thanks again to those that have asked for their names to be included. We have not received word from Alberta Health/AHS yet about when OTs might be needed or what they might be tasked to do. We will notify you when/if the call comes.
To be added to the Emergency Roster please contact the Registrar at firstname.lastname@example.org.
Again, please know that our thoughts are with you, your families and co-workers during these ever-evolving and challenging times. Please feel free to reach out if you have any further questions. Email is the easiest way to contact us.