interim regional exposure control plan – …ipac.vch.ca/documents/covid-19/recovery...

OH&S

Version: 1.0 Date of Last Revision: May 22, 2020 Replaces: N/A Originally Created: May 22, 2020

INTERIM REGIONAL EXPOSURE CONTROL PLAN – CORONAVIRUS

Note:

Some hyperlinks in this document may be accessible only through the Vancouver Coastal Health network. If you do not have an electronic copy or if you are outside the Vancouver Coastal Health network, please contact Employee Safety.

Interim Regional Exposure Control Plan VCH Employee Safety

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Version: 1.0 | Last Revision: May 22, 2020 | Replaces: N/A | Originally Created: May 21, 2020

Table of Contents Table of Contents .......................................................................................................................... 1

1.0 Introduction ............................................................................................................... 2

1.1 Purpose .................................................................................................................................... 2

1.2 Scope ........................................................................................................................................ 2

1.3 Applicable Regulations and Standards .................................................................................... 2

2.0 Roles and Responsibilities .......................................................................................... 3

2.1 Vancouver Coastal Health: .......................................................................................................... 3

2.2 Managers: ................................................................................................................................... 4

2.3 Employees ................................................................................................................................... 4

2.4 Employee Safety department ..................................................................................................... 5

2.5 Infection, Prevention, and Control (IPAC) Department .............................................................. 5

2.6 Professional Practice ................................................................................................................... 5

2.6 Joint Occupational Health and Safety Committee (JOHSC) ........................................................ 6

3.0 Risk Assessments ....................................................................................................... 6

3.1 Point of Care Risk Assessments .................................................................................................. 6

3.2 Risk Evaluation ............................................................................................................................ 6

4.0 IPAC Key Principles .................................................................................................... 9

4.1 Selection of IPAC Key Principles .................................................................................................. 9

4.2 Review of IPAC Key Principles ..................................................................................................... 9

5.0 IPAC Recovery Infection Control Checklist ................................................................................ 9

5.1 JOHSC Inspections ..................................................................................................................... 10

6.0 Education/Training Records ................................................................................................... 10

7.0 Health Surveillance and Exposure Records ............................................................................. 10

10.0 Version Control Table ........................................................................................................... 11


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1.0 Introduction

1.1 Purpose

The Interim Regional Exposure Control Plan – Coronavirus (hereafter known as the “Regional ECP”) outlines the existing plan to ensure the safety of staff with regards to the Coronavirus (COVID-19). The Regional ECP provides the framework in accordance to the requirements under the applicable WorkSafeBC (WSBC) regulations. The Regional ECP is written as a companion to the existing documents “VCH Regional Pandemic Outbreak Response Plan” and the “VCH Infection Prevention and Control Outbreak Management: Influenza-like illness (ILI) Outbreak Protocol 2019-2020 Season” or “Eflubinder: Long-term care influenza guide.” The Regional ECP should not be used independently without the aforementioned documents. 1.2 Scope

The Regional ECP is applicable for all VCH Locations including Acute, Community, Residential, and Corporate locations.

1.3 Applicable Regulations and Standards

The Regional ECP makes reference to the applicable Worker’s Compensation Act and Occupational Health and Safety Regulation enforced by WSBC.

• Occupational Health and Safety Regulations, Section 5.54 – Exposure Control Plan • Occupational Health and Safety Regulations, Section 6.34 – Exposure Control Plan

The Regional ECP also makes reference to applicable Ministry of Health directive relating to COVID-19

• Ministry of Health Communique: Infection Prevention and Control for Novel Coronavirus (COVID-19)

The Regional ECP also makes reference to applicable BC CDC Guidance documents for Clinical Care relating to COVID-19.

• BC CDC COVID-19 Clinical Care

The Regional ECP also makes reference to the VCH Influenza Prevention and Occupational Health and Safety policies.

https://sneezesdiseases.com/resource/vch-regional-pandemic-outbreak-response-plan/open

http://ipac.vch.ca/Documents/Outbreak/VCH%20Infection%20Control%20Influenza%20Outbreak%20Protocol.pdf


https://sneezesdiseases.com/resource/eflubinder

https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/covid-19-infection-prevention-control.pdf


http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/long-term-care-facilities-assisted-living

http://shop.healthcarebc.ca/vch/VCHPolicies/D-00-11-30042.pdf




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2.0 Roles and Responsibilities

• Regional roles and responsibilities are outlined in the “VCH Pandemic Outbreak Response Plan” within Chapter 1 – Overview.

• Local site responsibilities in the event of an outbreak are assigned to the influenza lead and are outlined in the VCH Infection Prevention and Control Outbreak Management: Influenza-like illness (ILI) Outbreak Protocol 2019-2020 Season under ILI Introductions and Definitions. Additional roles and responsibilities are also outlined in the VCH Influenza Prevention policy.

2.1 Vancouver Coastal Health:

• Ensure that Safety plans will follow WSBC’s 6 step returning to safe operations process : Assess the risks at your workplace, implements protocols to reduce risks, develop appropriate polices, develop communication plans and training , monitor the workplace and update plans as necessary and assess and address risks form resuming operations.

• Ensure a copy of the site specific safety plan is posted and includes feedback from worker. • Through the Emergency Operations Centre (EOC) or Administration, modify service models and

levels, using a risk-based approach when addressing identified concerns, unless otherwise ordered by a national, provincial and/or local regulatory authority.

• With respect to providing healthy/safe working environments, ensure that Operational leaders (e.g. managers/supervisors) are informed of, and adhere to, the directions provided through the EOC and/or Administration.

• Adhere to the Hierarchy of Controls as outlined by the Ministry of Health related to the reduction of exposure risks and ensure necessary resources including, but not limited to, engineering controls, administrative controls, and appropriate Personal Protective Equipment (PPE).

• Support necessary stakeholder groups, including the Joint Occupational Health and Safety (JOH&S) Committees

• Re-evaluate this plan as necessary to ensure that it remains viable and appropriate; in the event of a disruption/failure in this plan, advise the appropriate Agency (Agencies) and re- evaluate/revise as necessary.

https://sneezesdiseases.com/assets/uploads/1578342909B2QYPNFREK5cN5EDsglaGYPKRX9A.pdf





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2.2 Managers:

• Ensure that IPAC: Recovery and Safety Plan: Key Principles documents in the form of practical took kits are reviewed, customized, and implemented for their departments to identify areas/activities that may increase the risk of exposure to COVID-19. (see Appendix A: COVID-19 IPAC Key Principles Tool kits )

• Support the Joint Occupational Health and Safety Committee with the inspection of the facility as part of the IPAC Recovery Control Checklist process

• Adhere to the directions provided by the Organizational leadership, organizational stakeholder groups (e.g. OH&S and IPAC Departments, JOH&S Committees, etc.), and external stakeholder groups (e.g. WorkSafeBC).

• Share awareness and informational resources with employees and others within departments/sites under his/her leadership.

• Where applicable, facilitate the development/provision of Standard Operating Procedures (SOP’s) and direct work in a manner that minimizes/eliminates exposure risks to employees.

• Where applicable, provide appropriate Personal Protective Equipment (PPE) and other equipment/controls.

• Where applicable, facilitate worker education/training pertaining to the selection, care, maintenance and use of any PPE (including fit testing for those employees who may be issued a respirator).

• Ensure all workers follow SOP’s and appropriately use PPE (e.g. gloves, gowns, eye protection, masks/respirators, etc.).

• Provide information/feedback regarding employee comments/concerns to site/portfolio leadership, and other stakeholders including, but not limited to: Human Resources (including Occupational Health & Safety (OH&S)), Infection Prevention & Control (IPAC), Professional Practice, etc.

2.3 Employees

• Adhere to the directions provided by departmental/site/program leadership, organizational stakeholder groups (e.g. the OH&S and IP&C departments, JOH&S Committees, etc.), and external stakeholder groups (e.g. WorkSafeBC).

• Attend and participate in education/training/instruction sessions (including respirator fit-testing, where applicable).

• Review and adhere to applicable SOP’s. • Select, care, maintain and use PPE as per education/training.


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• Understand how exposures can occur and when/how to report exposure incidents. • Report feeling unwell to leadership immediately and follow directions regarding isolation, etc. • Direct questions to leaders and/or appropriate stakeholder groups.

2.4 Employee Safety department

• Ensure that the 6 steps returning to safe operation as outlined by WSBC is being followed • Ensure site specific safety plans are reviewed and customized using the tool kit approach. • Ensure the safety plan is as required and updated as necessary. • Support the development of measures and resources to support both physical and mental health

wellness and safety. • Ensure a system for documenting instruction, training and fit testing is in place. • Assist with implementation of the ECP by using the practical tool kit approach and consult on

risk controls, as needed.

2.5 Infection, Prevention, and Control (IPAC) Department

• Develop and maintain the guiding principles for Infection Prevention and Control and Public Health to limit the spread of COVID-19.

• Select, implement and document the appropriate site or scenario specific control measures using the tool kit.

• Ensure leaders and workers are educated and trained to an acceptable level of competency.

2.6 Professional Practice

• Provide clinical practice guidance as it relates to staff/patient safety and COVID-19. • Assist with the implementation of the ECP through the tool kit approach and consult on risk

controls, as needed.


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2.6 Joint Occupational Health and Safety Committee (JOHSC)

• Facilitate the inspection of the facility utilizing the toolkit resources provided in the ECP. • Be available to answer questions from staff. • Support review and development of resources. • Be a partner in assessing risks and implementing protocols at the workplace by helping to

identify areas where people gather, job tasks and processes where workers are close to one another or the public, the tools, machinery and equipment workers share while working and surfaces that people touch often such as door knobs, elevator buttons

3.0 Risk Assessments

3.1 Point of Care Risk Assessments

Risk Assessments must be performed in the point and time of the task. This is because the circumstance of each task are unique and will impact the potential for occupational exposure. The health care professional will follow the Risk Assessment process outlined in the VCH Regional Pandemic Outbreak Response Plan – Chapter 3 Infection Control Guidelines. The health care professional will also follow updated guidance from Ministry of Health Communique: Infection Prevention and Control for Novel Coronavirus (COVID-19).

3.2 Risk Evaluation

The risk assessment table (*Table 1) and Figure 1 has been developed using reference materials obtained from:

a. The Ministry of Health; b. The Provincial Medical Health Officer; c. Island Health Infection Prevention and Control Manual; d. WorkSafeBC’s Occupational Health & Safety Regulation:

• Regulation 5.54 “Controlling Exposure - Exposure Control Plan”, • 6.34 “Biological Agents - Exposure

Control Plan,” ; and e. WorkSafeBC’s Occupational Health & Safety Guidelines

• G6.34-6 “Exposure Control Plan - Pandemic Influenza”



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All workplaces must evaluate the level of risk related to COVID-19 and implement controls and measures to minimize the risk. The BC Government’s Go Forward Strategy [2] uses the following matrix to illustrate level of risk to consider when evaluating risk. The greater the number of contacts and the greater the contact intensity (function of distance and duration), the greater the risk of staff being exposed to and contracting COVID-19. The goal of the risk assessment is to determine the level of risk and implement controls to adequately mitigate that risk.

Figure 1: Risk Matrix

The BC Government’s Go Forward Strategy identifies three areas which form the core measures of the “new normal” for which organizations must plan: personal control measures, social interaction measures and organizational practices. The “new normal” is expected to be in place for the next 12 - 18 months, until a safe and effective vaccine or treatment is created or until herd immunity has been reached in the population. Core personal control measures

• Physical distancing • When physical distancing cannot be maintained

o Engineering controls (e.g. Plexiglas barriers or partitions) o PPE as prescribed by the provincial PPE framework

• No hand shaking • Good hygiene practices • Frequent hand washing


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• Avoid touching the face • Practicing respiratory etiquette • Frequent disinfection of high touch surfaces • Do not come to work with cold, flu or COVID-19 symptoms • Extra precautions for vulnerable individuals

Core social interaction measures

• Physical distancing practices in staff rooms, kitchens and other gathering places • Increased cleaning & disinfecting throughout

Core organizational practices

• Policies such as not coming to work when sick as well as policies to support being off sick more often in the next 12 months

• Office-based organizations: o work from home part of the time to reduce contact intensity and number of contacts o for those who must still come to work, staggered shifts or work hours, smaller work

teams working virtually, foregoing in-person meetings as much as possible

• Focussing on higher risk individuals (over age 60 or those underlying medical conditions) • Higher levels of cleaning for high touch surfaces • Hand sanitizer available at entrances and throughout the workplace • Physical barriers where appropriate (e.g. serviced counters (e.g. reception))

Hierarchy of Controls

The hierarchy of controls gives us a way to conceptualize and evaluate the effectiveness and impact of controls and helps inform decision-making when choosing controls to maintain safety and prevent the spread of COVID-19. The hierarchy of controls is:


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4.0 COVID-19 Recovery: Public Health and Infection Control Key Principles and Safety Plan

Infection Prevention and Control Key Principles documents have been developed for the following settings within VCH. Appendix A

• Acute Care • Ambulatory Care • Community Care (in progress) • Long-term Care (in progress) • Corporate (in progress)

Key principles have been classified based on the hierarchy of controls as an indication of effectiveness at controlling COVID-19.

4.1 Selection of IPAC Key Principles

Facilities may have one or more of settings where the IPAC Key Principles document applies. Each facility is required to select and implement the IPAC Key Principles applicable to their setting in order to reduce the risk of COVID-19 within their location. Selection should be done in consultation with the JOHSC and/or representative selection of staff working in that location.

4.2 Review of IPAC Key Principles

Manager, JOHSC and/or representative selection of staff working in the location must review the IPAC Key Principles documentation to implement measures at reducing the risk of COVID-19 within their facility. Where there are unique elements to the Key Principles document, the location must add or remove from the listing so that the IPAC Key Principles document reflects the measures put in place to ensure the safety of all personnel in the facility.

5.0 IPAC COVID-19 Recovery Checklist

IPAC Recovery Infection Control Checklists have been developed to monitor the implementation of the IPAC Key Principles for each facility and setting. The checklists mirror each IPAC Key Principles document and is available in Appendix B.


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5.1 JOHSC Inspections

In order to support the reduction of risk from exposure to COVID-19, JOHSC members have been tasked to support the work environment through completion of the IPAC Recovery Infection Control Checklist for the facility they support. JOHSC members will be asked to

1) Coordinate an Inspection Team 2) Review the IPAC Recovery and Safety Plan: Key Principles and Recovery Infection Control

Checklist 3) Conduct the inspection 4) Report back to the Manager and JOHSC about the inspection and any deficiencies 5) Support resolution of the deficiencies by making recommendations

Inspections should take place as soon as measures have been put into place to reduce the risk of exposure to COVID-19.

Once inspections have been completed, they must be submitted to [email protected] for tracking and record keeping purposes.

6.0 Education/Training Records Each facility is responsible to provide education to their staff on measures to protect their own safety. The education elements required are outlined in the VCH Regional Pandemic Outbreak Response Plan – Chapter 3 Infection Control Guidelines. VCH staff are required to complete the LearningHub Infection Prevention and Control Practices for Direct/Professional Clinical Care Providers education. Education records are maintained within LearningHub

7.0 Health Surveillance and Exposure Records Health surveillance and records keeping is outlined in the VCH Regional Pandemic Outbreak Response Plan – Chapter 2 Surveillance Testing is available to all individuals with new respiratory or systemic symptoms compatible with COVID-19, however mild. Symptoms may include fever, chills, cough, shortness of breath, sore throat, odynophagia, rhinorrhea, nasal congestion, loss of sense of smell, headache, muscle aches, fatigue or loss of appetite.

mailto:[email protected]

https://learninghub.phsa.ca/Courses/8300/infection-prevention-and-control-practices-for-direct-professional-clinical-care-providers

https://learninghub.phsa.ca/Courses/8300/infection-prevention-and-control-practices-for-direct-professional-clinical-care-providers


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Exposure records are managed in partnership between Public Health and the Provincial Workplace Health Call Centre for VCH staff. If staff have tested positive, they are followed by Public Health, and the Provincial Workplace Health Call Centre to determine appropriate care and restrictions as required. For VCH staff, records are then maintained by the Provincial Workplace Health Call Centre. Instructions for staff to report exposures and illness will follow with existing reporting practices with the facility which includes reporting to the Provincial Workplace Health Call Centre for occupational exposures.

8.0 Employee Supports Mental and Physical Health for our staff and physicians health is paramount at VCH.

If employees are concerned about physical symptoms support is offered through a variety of sources including the Satellite Assessment Centre, BC CDC and 811. Information about this is available through the MyVCH COVID-19 (https://my.vch.ca/covid19)

If Employees report feeling worried/anxious about COVID-19 related issues, the following resources are available through Employee Wellness (1.800.505.4929)

• Confidential counselling through Employee and Family Assistance Program

• Coping with COVD daily webinars, health coaching and wellness supports through their “Taking care of me” workshop series

• 24/7 Crises line

• Critical incident stress Debriefings ( CISDs)

9.0 Version Control Table

Version Number Summary of Purpose and/or Change(s) Date 1.0 Creation of document May 22, 2020

https://my.vch.ca/covid19


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Appendix A - COVID-19 Recovery: Public Health and Infection Control Key Principles and Safety Plan: Tool kits

1

COVID-19 Recovery: Public Health and Infection Control Key Principles & Safety Plan

For Acute Care Settings

Updated: 25 May 2020 Please note that VCH is taking the necessary precautions to provide the best possible care in a safe environment for our patients, residents, visitors, staff and medical staff. Every patient needing care, regardless of COVID-19 status, is welcomed at VCH. Please follow Public Health guidelines and Infection Control principles when planning your recovery efforts for your area of work. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. Please note: amendments to this document will occur as COVID-19 recovery phases evolve.

The Key Principles & Safety Plan has been divided into leveled measures of precautions each having an increasing level of effectiveness. Please refer to the color legend below:

Elimination/Substitution

Engineering

Administrative

Personal Protection

Other strategy

Quick Reference: 1. Patients/Clients

a. Urgent/Emergent/Elective Surgical Procedures b. Diagnostic Procedures c. When arriving at the hospital d. During hospital stay e. After hospital stay

2. Family/Visitors/Support a. Virtual visits b. In-person visits

3. Personnel/Staff/Medical Staff a. Staff/Medical Staff providing direct patient care (e.g., nurses, physicians, allied, contracted

services etc.) b. Staff/Medical staff not providing direct patient care (e.g., reception, nursing station,

contracted services etc.) c. Administrative staff, offices, and all other staff not working in direct patient care

4. Equipment/Supplies/Environment a. Elevators and stairwells b. Cleaning and disinfecting clinical, administrative and public areas c. Layout and Flow

http://www.vch.ca/covid-19

http://ipac.vch.ca/Pages/Emerging-Issues.aspx

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1. Patient/Clients

Urgent/Emergent/Elective Surgical Procedures: Urgent procedures should proceed as medically indicated, regardless of the patient/client’s COVID-19 status, and should not be delayed for testing or test result.

For scheduled procedures, patients/clients should receive a pre-admission package that includes instructions regarding self-assessment for COVID. The self-assessment tool is available on the BC Centre for Disease Control (BCCDC) website: https://bc.thrive.health/. Please advise patients to follow the recommendations from the self-assessment or to contact 8-1-1 or their primary care provider.

For urgent or emergent treatments, patients/clients reporting new symptoms consistent with COVID-19 should undergo pre-operative COVID-19 testing.

Elective surgical patients should self-monitor for symptoms prior to surgery and phone their surgeon’s office if they develop any signs or symptoms consistent with COVID-19 or have contact with any confirmed COVID-19 individuals.

Elective surgical procedures for confirmed COVID-19 patients and those patients who have had contact with, or an exposure to, a COVID-19 patient (known and being followed by public health officials) should be delayed until the patient is deemed recovered and non-infectious according to the provincial protocols, or the surgical procedure becomes urgent or emergent.

Elective surgical patients reporting new symptoms consistent with COVID-19 should be tested as per provincial testing guidelines.

For scheduled surgical procedures, the COVID-19 Surgical Patient Assessment Form should be completed 24 to 72 hours prior to scheduled surgical procedure, by the pre-admission unit (nurse, medical office assistant or anesthesiologist) over the phone, and then repeated in person when the patient arrives at the hospital on the day of surgery. - For urgent or emergent surgical procedures, the COVID-19 Surgical Patient Assessment Form shall

be completed upon arrival to the pre-operative area. - There needs to be a mechanism in place within each facility or surgical unit to ensure the COVID-19

Surgical Patient Assessment Form is included in the patient chart.

Please refer to the guidelines applicable to the patient population: o Adults o Obstetrics o Paediatrics

Diagnostic Procedures:

Patients/clients should receive a pre-admission package that includes instructions regarding self-assessment for COVID. The self-assessment tool is available on the BC Centre for Disease Control (BCCDC) website: https://bc.thrive.health/. Please advise patients to follow the recommendations from the self-assessment or to contact 8-1-1 or their primary care provider.

Medical Office Assistants (MOAs) or clerk should contact Patients/Clients by phone to determine if patients/clients or family members have developed COVID-19 like symptoms and have recent travel history. Please refer to the following script. - Elective procedures for confirmed COVID-19 patients and those patients who have had contact

with, or exposure to, a COVID-19 patient (known and being followed by public health officials) should be delayed until the patient is deemed recovered and non-infectious according to the provincial protocols, or the procedure becomes urgent or emergent.

https://bc.thrive.health/

http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_IPCProtocolSurgicalProceduresAdult.pdf

http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_IPCProtocolSurgicalProceduresObstetrical.pdf

http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_IPCProtocolSurgicalProceduresPediatric.pdf


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Acute/Script_%20Appointment%20Reminders_Acute%20Care.pdf

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Patients/clients should be reminded to notify staff of any changes in their health prior to coming to the hospital. - As above, please advise patients to follow the recommendations from the self-assessment tool

(https://bc.thrive.health/) or the recommendations outlined by 8-1-1 or their primary care provider.

Action: Please ensure that patients have hospital contact number to notify of any changes.

Patients/clients should be reminded that they will undergo the same screening assessment again when they arrive at the hospital.

Patients/clients should be notified that all procedures are subject to the discretion of the Most Responsible Care Giver (MRCG) and may be cancelled or rescheduled at any point.

When arriving at the hospital…

A) Screening at the hospital entry point(s) Recommend continuing controlled access with specific entry points for public access and staffed with greeters/security/volunteers.

At the entrance of the facility, general screening questions will be asked. Please refer to the following script. - Note: It is recommended to have a clinical partner at the entrance to support with

questions/concerns requiring clinical expertise. - Note: Clients/patients should maintain two meters distance from greeters/security/volunteers,

wear PPE, or have a physical barrier.

At arrival, patients/clients should perform hand hygiene.

Action: Ensure patients/clients remove gloves, if applicable, and perform hand hygiene. Gloves should not be put back on.

Action: Place posters at entrances to clinical areas as a reminder to practice frequent hand hygiene, physical distancing (if appropriate), and respiratory hygiene.

Only patients/clients with visible and/or self-declared COVID-19-like symptoms, who are not wearing a surgical/procedure mask already, will be required to wear a surgical/procedure masks provided by the Health Authority. - Other considerations: If the facility/site has physical distancing constraints, the use of masks for all

patients/clients, regardless of COVID-19 status, may be considered.

If the patient/client is not symptomatic, they can wear their own masks during their visit.

Action: ensure directions are accessible to avoid wandering while travelling to destination.

B) Screening at destination

At arrival, patients/clients should perform hand hygiene. As part of the check-in process, the patient/client will be asked screening questions. Please refer to the following script.

COVID-19-like symptomatic patients require droplet and contact precautions and will be directly placed in an exam room.

During hospital stay…

Throughout the visit, respiratory etiquette should be followed, including cover cough and sneeze and avoid touching the face, mouth, nose, eyes and masks.

Throughout the visit, patients/clients should perform hand hygiene. Follow Point-of-Care Risk Assessment as per Infection Prevention and Control recommendations.

If patients/clients cannot effectively be screened (e.g., dementia), share should use a Point-of-Care Risk Assessment to determine their level of risk at PPE required to provide safe care.

Any patients who develop COVID-19-like symptoms require droplet and contact precautions. When accessing common spaces (e.g., waiting room, lounge, cafeteria), patients/clients should perform


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Acute/Script_%20In%20Person%20Site%20Entry%20Points_Acute%20Care.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Acute/Script_%20In%20Person%20Screening%20at%20Reception_Acute%20Care.pdf

http://ipac.vch.ca/Documents/Routine%20Practices/PCRA%20Algorithm.pdf



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hand hygiene and maintain physical distancing throughout their visit.

After hospital stay…

As part of the discharge process, patients/clients should be provided with the appropriate discharge documentation outlining the necessary Public Health and Infection Control Practices they should follow.

Patients/clients should be provided with a mask if clinically indicated (e.g., on droplet precautions at time of discharge).

Patients/clients should perform hand hygiene before leaving the facility/building.

2. Family/Visitors/Support

To reduce risks of COVID-19 for patients, clients, family, residents and staff, virtual visits should be prioritized over in-person visits. Exceptions can be made for birth, death, compassionate reasons, and pediatrics. Please refer to the Guidelines for Visitation during COVID-19.

Virtual visits

Patients should be provided with alternatives to in-person visits.

Action: Define process and criteria for virtual visits (priority of patients/conditions, timing, storage and security, IT support, etc.)

Action: Ensure patients have access to and can use their own personal devices.

If needed, information on “How to request a tablet” and “Guidelines for Cleaning and Disinfection of Tablets” can be accessed here.

In-person visits

Limit number of visitors to 1-2, once per day for 2 hours, with some exceptions permitted. (e.g., pediatric and maternity patients, patients with complex care needs including behavioral or mental health needs).

Recommend continuing controlled access with specific entry points for public access and staffed with security and/or volunteers.

At the entrance of the facility, screening questions will be asked. Please refer to the following script. - Note: Family/visitors/support should maintain two meters distance from

greeters/security/volunteers, have a physical barrier or wear PPE. - Note: Family/visitor/support who do not present with COVID-19-like visible symptoms can wear

their own masks during their visit.

Family/visitor/support who present with visible and/or self-declared COVID-19-like symptoms should not be permitted to enter the facility for the safety of patients and staff.

At arrival, family/visitors/support should perform hand hygiene.

Action: Ensure patients/clients remove gloves, if applicable, and perform hand hygiene. Gloves should not be put back on.

Action: Place posters at entrances to clinical areas as a reminder to practice frequent hand hygiene, physical distancing (if appropriate), and respiratory hygiene.

Family/visitors/support can wear their own masks during their visit if no COVID-19-like symptoms present.

Action: Place posters at entrances to clinical areas to remind and support visitors of frequent hand hygiene, physical distancing (if appropriate), and respiratory hygiene.

Family/visitors/support must agree to restrict the visit to 2 hours per visit and avoid gathering in public spaces, if possible (e.g., cafeteria, lounges, waiting areas).

Action: Place signage with friendly reminders for visitors

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Visitation/Final%20Guidelines%20for%20Visitation%20during%20COVID-19.pdf

https://my.vch.ca/dept-project/Virtual-Health/Virtual-Health-Communications/Pages/Tablets.aspx

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Script_%20In%20Person%20Site%20Entry%20Points_Acute%20Care.pdf

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Throughout the visit, respiratory etiquette should be followed, including cover cough and sneeze and avoid touching the face, mouth, nose, eyes and masks.

Family/visitors/support who are visiting active and suspected COVID-19 positive patients must don appropriate PPE supplied by the Site (contingent on accessibility and availability).

Action: Frontline staff should provide education on how to safely put on and remove PPE

3. Personnel/Staff/Medical Staff

Staff/Medical Staff providing direct patient care (e.g., nurses, physicians, allied, contracted services etc.)

Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace

Staff/Medical staff should not come to work with COVID-19-like symptoms. - If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a

surgical/procedure mask, complete any essential tasks, notify manager if appropriate, then leave work.

- Staff/medical staff are to also call the Provincial Workplace Call Centre (1-866-922-9464). - Testing is strongly recommended, and timing for return to work will be determined by Public

Health.

Staff/Medical staff must practice effective hand hygiene before, during and after each patient – cleaning their hands with soap and water or an alcohol-based hand sanitizer.

Staff/Medical staff should follow respiratory etiquette, including cover cough and sneeze and avoid touching the face, mouth, nose, eyes and mask. Perform hand hygiene if mask is touched/removed/adjusted.

Staff/Medical staff should consider designated work clothing and change when going home. A clean area should be setup to allow storage of clean clothing. Consider showering prior to going home. Clothing to be laundered should be removed daily to prevent accumulation.

Where possible, staff/medical staff should follow cohort starring or be scheduled together in teams or groupings to minimize the interaction.

Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment. Where feasible, maintain 2 meters of distance between others.

Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distancing. Safety huddles should still occur to share pertinent information to work safely.

Staff/Medical staff should be encouraged to clean and disinfect their own work space following the IPAC Guidelines. For shared work spaces, staff/medical staff should clean and disinfect space before and after use.

Each area should identify a designated examination/isolation room and/or waiting area for placement of patient presenting with COVID-19 symptoms, follow your IPAC guidelines for patient placement.

Staff/ Medical staff should review COVID-19 information and implement a Point-of-Care Risk Assessment to determine whether there are any additional precautions required for the procedure.

If a patient/client with COVID-19-like symptoms requires diagnostics, surgery or any other procedure, try to schedule at the end of the day, if possible. - If that is not possible and the patient/client must be seen during the day, then the examination

room should be closed until terminal/isolation clean can be performed by environmental services. - If the examination room cannot be closed, Staff/Medical Staff should clean and disinfect high touch

points using appropriate disinfectant wipes. Refer to VCH’s Cleaning and Disinfecting Guidelines.

https://my.vch.ca/news-discussion-site/Documents/COVID-19-Cleaning-Disinfecting-Workspaces.pdf

http://ipac.vch.ca/Documents/Acute%20Resource%20manual/VCH%20Diseases%20and%20Conditions%20Table.pdf



http://ipac.vch.ca/Documents/Cleaning%20and%20Disinfection/Low%20Level%20Cleaning%20Disinfecting.pdf

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If a patient with non COVID-19-like symptoms, Staff/Medical Staff should follow routine department practices for cleaning and disinfection between patients.

Staff/Medical staff should limit the exchange of papers. If documents must be exchanged, leave them on a clean surface.

Staff/Medical staff should avoid sharing pens and other office equipment.

Staff/Medical staff should avoid handshakes and any other physical contact with others.

Staff/Medical staff should avoid sharing food and snacks.

For the most up-to-date PPE recommendations, refer to the IPAC document for the Acute Setting.

Staff/Medical staff not providing direct patient care (e.g., reception, nursing station, contracted services etc.)

Personnel should be minimized through the transition and to reduce the number of interactions in the workplace, where feasible.




Health.

Staff/Medical staff must perform frequent hand hygiene.

Staff/Medical staff should follow respiratory etiquette, including cover cough and sneeze and avoid touching the face, mouth, nose, and eyes. Perform hand hygiene if mask is touched/removed/adjusted. Where feasible, maintain 2 meters of distance from others.

Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distancing. Safety huddles should still occur to share pertinent information to work safely.

Staff/Medical staff should be encouraged to clean and disinfect their own work space following the IPAC Guidelines.

Medical staff should limit the exchange of papers. If documents must be exchanged, leave them on a clean surface.

Staff/Medical staff should avoid sharing pens and other office equipment.

Staff/Medical staff should avoid handshakes and any other physical contact with others.

Staff/Medical staff should avoid sharing food and snacks.

For the most up-to-date PPE recommendations, refer to the IPAC document for the Acute Setting.

Administrative staff, offices, and all other staff not working in direct patient care

Shared workstations should be minimized where possible to reduce cross-interaction with surfaces.

Follow “Staff/Medical staff not providing direct patient care” guidelines above.

http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/PPE_Recommendations_%28Acute%29_V2.pdf



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4. Equipment/Supplies/Environment

HVAC systems should be examined to reduce recirculation of air in both clinical and non-clinical areas. Indoor air temperature and humidity should be maintained for any adjustments to the system

Pets and other animals other than those identified as Certified Guide or Service animals should be limited from facility

Elevators and stairwells

Physical distancing is encouraged in elevators. - Elevator occupancy number will vary according to size of the elevator and social distancing

requirements. The capacity for elevators will be defined by local EOCs in partnership with Public Health and Infection Prevention and Control.

Recommendations to consider: o Small Elevator – 2 people maximum o Large Elevator – 4- 6 people maximum o Masks can permit increased occupancy.

An elevator monitor is recommended to assist and direct accordingly.

Action: Place posters to remind of elevator etiquette, physical distancing and place floor layout in the queue line and inside the elevators to guide users.

Encourage staff who are able to use stairwells while maintaining physical distance reduce elevator crowding.

Cleaning and disinfecting clinical, administrative and public areas

Cleaning clinical areas. - During the examination any medical/clinic equipment used (e.g., blood pressure cuffs, clipboard)

should be cleaned and disinfected by the direct care provider using the routine department practices for cleaning and disinfecting between patients.

o When possible, single use equipment and supplies are recommended. - Common areas and high-touch surface areas should be cleaned and disinfected at least once a day,

with a focus on high touch points such as reception counters, seating areas (including clinic room seats and armrests), doors, handrails, light switches, door handles, toilets, taps, handrails , phones, keyboards, and counter tops. The frequency and who conducts cleaning activities will be defined by local EOCs in partnership with Public Health and Infection Prevention and Control.

- For cleaning, disinfecting and frequency of equipment instructions, refer to the Infection Prevention and Control Master Equipment Cleaning and Disinfection Manual and/or refer to the facilities manual for specific equipment/supplies cleaning recommendations.

Cleaning other clinical areas - Other clinical areas such as lunch rooms, lounges, and offices on the unit should be cleaned and

disinfected on a daily basis, and when needed.

Cleaning Administrative Offices - Follow the routine department practices for cleaning and disinfection.

Cleaning Public Areas - Public areas, such as hallways and stairways, should be cleaned and disinfected on a daily basis, and

when needed.

All staff are recommended to clean and disinfect their own or shared work space/WOW following the IPAC Guidelines.

De-clutter and minimize equipment and supplies so effective environmental cleaning can be achieved.

Layout and flow

Recommend using automatic door plates, where available.

http://ipac.vch.ca/Documents/Cleaning%20and%20Disinfection/VCH%200291.pdf



8

Hand hygiene stations should be available and easily accessible at all doorway entrances and exits.

Action: Ensure appropriate hand hygiene are in place and hand hygiene products are maintained

Staff shared spaces, waiting rooms, cafeterias, coffee shops and common areas (lounges) seats should be spaced to maintain a physical distancing. - If staff lounge not large enough to accommodate physical separation, consider staggered breaks or

alternative break areas. - Recommendations to consider:

All seating should be two meters apart. If this is not possible, tape off enough seating to maintain two meters separation.

Non-essential items (remote control, magazines, toys, etc.) should be removed from waiting and gathering areas. Refer to the De-clutter Audit Tool.

Products (e.g., creams, lotions) are dedicated to a single user, when possible.

Alternative solutions to waiting in the common areas should be considered. Some can include: text message and/or call when patient is ready to be seen.

Reception area and clinic hallways should have visual cues to assist in physical distancing (two meters) and if possible, one way directional flow.

Patient/client room recommendations are as follows: - For COVID-19 Positive Patients:

Cohort or private rooms only. - For COVID-19 Suspect Patients or those on droplet/contact precautions:

Private rooms required. - All other patients:

Private room, when possible. If 2-4 bed rooms, use curtains to separate patients and monitor patients’ status on an

regular basis (minimum daily) to readily identify suspect patients throughout admission. Use caution with shared bathrooms, ensure regular cleaning as part of unit

cleaning schedule.

http://ipac.vch.ca/Documents/Cleaning%20and%20Disinfection/VCH%20Unit%20Environmental%20Declutter%20Audit%20Tool.pdf

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For Ambulatory Care Settings

Updated: 25 May 2020 Please note that VCH is taking the necessary precautions to provide the best possible care in a safe environment for our patients, residents, visitors, staff and medical staff. Every patient needing care, regardless of COVID-19 status, is welcomed at VCH. Please follow Public Health guidelines and Infection Control principles when planning your recovery efforts for Ambulatory Care. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. A checklist has been developed for the Ambulatory care setting that supports the implementation of the key principles outlined within this document. Please note: amendments to this document will occur as COVID-19 recovery phases evolve. Quick Reference:

1. Patients/Clients a. Virtual visits b. In person visits

2. Family/Visitors/Support 3. Personnel/Staff/Medical Staff

a. Staff/Medical Staff providing direct patient care (e.g., nurses, physicians, allied, contracted services etc.)

b. Staff/Medical Staff not providing direct patient care (e.g., reception, nursing station, contracted services etc.)

c. Administrative staff, offices, and all other staff not working in direct patient care 4. Equipment/Supplies/Environment

a. Elevators and stairwells b. Cleaning and disinfecting clinical, administrative and public areas c. Layout and flow


Elimination/Substitution Engineering Administrative Personal Protection Other strategy



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1. Patient/Clients

Virtual visits To reduce the patient flow in the clinic, virtual visits and telephone-consultation should be prioritized over in-person appointments. Patients should be provided with alternatives to in-person appointments. � Action: Define process and criteria for virtual visits (priority of patients/conditions, timing, storage

and security, IT support, etc.)

For cleaning and disinfecting electronic devices, follow the VCH Guidelines for Cleaning and Disinfecting Devices.

In person visits Initial patient and client bookings may need to be limited in order to ensure that patients/clients can follow physical distancing recommendations while accessing services, but may need to be prioritized by urgency. � Action: Local EOC in partnership with medical leadership will determine the number of patients to

be seen per Clinic.

Before coming to the clinic… Medical Office Assistants (MOAs) and/or clerk should connect with Patients/Clients by phone to determine if patients/clients or family members have developed COVID-19-like symptoms and have recent travel history. Please refer to the following script. - If patient has any COVID-19-like symptoms, the Medical professionals should determine if patient

needs to be seen in person or virtual visit is possible.

Patients/clients should be reminded to notify staff of any changes in their health prior to coming to clinic. - The self-assessment tool is available on the BC Centre for Disease Control (BCCDC) website:

https://bc.thrive.health/. Please advise patients to follow the recommendations from the self-assessment or to contact 8-1-1 or their primary care provider.

� Action: Ensure that patients have clinic contact number to notify.

Patients/clients should be reminded that they will undergo screening assessment at many point throughout their clinic visit (e.g.: Phone pre-booking, at the entrance of the facility, at the clinic level, etc.)

When arriving at the clinic… A) Screening at the hospital entry point(s)

Recommend continuing controlled access with specific entry points for public access and staff with security and/or volunteers.

At the entrance of the facility, greeters/volunteers will conduct screening. Please refer to the following script. - Note: It is recommended to have a clinical partner at the entrance to support with

questions/concerns requiring clinical expertise. - Note: Greeters/security/volunteers should maintain two meters distance with clients/patients,

wear PPE, or have a physical barrier.



http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20Appointment%20Reminders_Ambulatory.pdf


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20In%20Person%20Screening%20at%20Site%20Entry%20Points_Ambulatory.pdf

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At arrival, patients/clients should perform hand hygiene. � Action: Ensure patients/clients remove gloves, if applicable, and perform hand hygiene. Gloves

should not be put back on. � Action: Place posters at entrances to clinical areas to remind and support visitors of frequent hand

hygiene, physical distancing and respiratory hygiene.

Only patients/clients with visible and/or self-declared COVID-19-like symptoms, who are not wearing a surgical/procedure mask already, will be required to wear a surgical/procedure masks provided by the Health Authority. - Other considerations: If the facility/site has physical distancing constraints, the use of masks for all

patients/clients, regardless of COVID-19 status, may be considered.

If the patient/client is not symptomatic, they can wear their own masks during their visit. B) Screening at destination

At arrival, patients/clients should perform hand hygiene. As part of the check-in process, the patient/client will be asked screening questions. Please refer to the following script.

COVID-19-like symptomatic patients require droplet and contact precautions and will be directly placed in an exam room.

During clinic stay… Throughout the visit, respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and, if applicable, mask.

Throughout the visit, patients/clients should perform hand hygiene. Follow Point-of-Care Risk Assessment as per Infection Prevention and Control Recommendations. - If patient/client cannot effectively be screened (e.g. dementia), staff should use a Point-of-Care Risk

Assessment to determine their level of risk and PPE required to provide safe care.

COVID-19-like symptomatic patients require droplet and contact precautions. Patients/clients should maintain physical distancing throughout their visit. After clinic visit… Patients/clients should perform hand hygiene before leaving the clinic and facility/building.

2. Family/Visitors/Support To reduce risks of COVID-19 for patients, clients, family, residents and staff, virtual visits should be prioritized over in-person visits. Exceptions can be made for birth, death, compassionate reasons, and pediatrics. Please refer to the Guidelines for Visitation during COVID-19.

Family, visitors and support should be limited to 1 per patient. Family/visitor/support who present with COVID-19 like visible symptoms should not be permitted to enter the facility for the safety of patients and staff.

Follow “patient/client guidelines” above.

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20In%20Person%20Screening%20at%20Clinic%20Reception_Ambulatory.pdf





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Staff/Medical Staff providing direct patient care (e.g. nurses, physicians, allied, contracted services etc.) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace Staff/Medical staff should not come to work with COVID-19-like symptoms. - If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a



Health.

Staff/Medical staff must practice effective hand hygiene before, during and after each patient - washing their hands with soap and water or an alcohol-based hand sanitizer.

Respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and if applicable, mask.

Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment.

Each clinic should identify a dedicated room for direct placement of high risk/COVID-like symptomatic patients and waiting areas.

If a patient with COVID-19-like symptoms must be seen in the clinic, Staff/Medical staff should place the appointment at the end of the day if possible. - If not possible, then the patient should be seen in the dedicated room for direct placement of high

risk/COVID-19-like symptomatic patients. - Is possible, the examination room should be closed until terminal clean can be performed. - If the examination room cannot be closed, Staff/Medical Staff should clean and disinfect high touch

points using appropriate disinfectant wipes, following VCH Cleaning and Disinfecting Guidelines.


Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distance.

Staff/Medical staff should limit the exchange of papers, shared pens and other office equipment. Staff/Medical staff should avoid handshakes and any other physical contact with others. Staff/Medical staff should avoid sharing food and snacks. For the most up-to-date PPE recommendations, refer to the IPAC document for the Ambulatory Care Setting.

Staff/Medical staff not providing direct patient care (e.g. reception) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace Staff/Medical staff should not come to work with COVID-19-like symptoms. - If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a



Health.


http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/PPE_Recommendations_%28Community%29.pdf


5

Staff/Medical staff must perform frequent hand hygiene. Respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and if applicable, mask.


Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distance.

Staff/Medical staff should limit the exchange of papers, shared pens and other office equipment. Staff/Medical staff should avoid handshakes and any other physical contact with others. Staff/Medical staff should avoid sharing food and snacks. For the most up-to-date PPE recommendations, refer to the IPAC document for the Ambulatory Care Setting.

Administrative staff, offices, and all other staff not working in direct patient care

Shared workstations should be minimized where possible to reduce cross-interaction with surfaces.

Follow “Staff/Medical staff not providing direct patient care” guidelines above.

4. Equipment/Supplies/Environment HVAC systems should be examined to reduce recirculation of air in both clinical and non-clinical areas. Indoor air temperature and humidity should be maintained for any adjustments to the system


Elevators and stairwells Physical distancing is encouraged in elevators. - Elevator occupancy number will vary according to size of the elevator and social distancing


• Recommendations to consider: o Small Elevator – 2 people maximum o Large Elevator – 4- 6 people maximum o Masks can permit increased occupancy.

• An elevator monitor is recommended to assist and direct accordingly. � Action: Place posters to remind of elevator etiquette, physical distancing and place floor

layout in the queue line and inside the elevators to guide users.

Encourage staff who are able to use stairwells while maintaining physical distance reduce elevator crowding.

Cleaning and disinfecting clinical, administrative and public areas Cleaning clinical areas. - During the examination any medical/clinic equipment used (e.g., blood pressure cuffs, clipboard)

should be cleaned and disinfected by the direct care provider using the routine department practices for cleaning and disinfecting between patients.

• When possible, single use equipment and supplies are recommended. - Common areas and high-touch surface areas should be cleaned and disinfected at least once a day,

with a focus on high touch points such as reception counters, seating areas (including clinic room




6

seats and armrests), doors, handrails, light switches, door handles, toilets, taps, handrails , phones, keyboards, and counter tops. The frequency and who conducts cleaning activities will be defined by local EOCs in partnership with Public Health and Infection Prevention and Control.




Cleaning Administrative Offices - Follow the routine department practices for cleaning and disinfection. Cleaning Public Areas - Public areas, such as hallways and stairways, should be cleaned and disinfected on a daily basis, and

when needed.

All staff are recommended to clean and disinfect their own or shared work space/WOW following the IPAC Guidelines.

De-clutter and minimize equipment and supplies so effective environmental cleaning can be achieved. Layout and flow

Recommend using automatic door plates, where available. Hand hygiene stations should be available and easily accessible at all doorway entrances and exits. � Action: Ensure appropriate hand hygiene are in place and hand hygiene products are maintained

Staff shared spaces, waiting rooms, cafeterias, coffee shops and common areas (lounges) seats should be spaced to maintain a physical distancing. � If staff lounge not large enough to accommodate physical separation, consider staggered breaks or

alternative break areas. � Recommendations to consider:

• All seating should be two meters apart. If this is not possible, tape off enough seating to maintain two meters separation.

Non-essential items (remote control, magazines, toys, etc.) should be removed from waiting and gathering areas. Refer to the De-clutter Audit Tool.

Products (e.g., creams, lotions) are dedicated to a single user, when possible. Alternative solutions to waiting in the common areas should be considered. Some can include: text message and/or call when patient is ready to be seen.

Reception area and clinic hallways should have visual cues to assist in physical distancing (two meters) and if possible, one way directional flow.





1


For Stand-Alone Administrative Offices

Updated: 26 May 2020 Please follow Public Health guidelines and Infection Prevention and Control principles when planning your recovery efforts for stand-alone administrative offices. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. Please note: amendments to this document will occur as COVID-19 recovery phases evolve.



Quick Reference: 1. Personnel/Staff/Contractors 2. External Visitors

a. Receiving visitors 3. Equipment/Supplies/Environment

a. Elevators and stairwells b. Cleaning and disinfecting administrative office suites and common areas c. Layout and flow



2

1. Personnel/Staff/Medical Staff Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace

Staff should not come to work with COVID-19-like symptoms. If staff become unwell during work to follow IPAC process for handover and report to supervisor/Provincial Workplace Call Centre.

Staff/contractors must perform frequent hand hygiene. Respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and if applicable, mask.

Staff/contractors should be encouraged to clean and disinfect their own work space following the IPAC Guidelines and to de-clutter and minimize equipment and supplies so effective environmental cleaning can be achieved.

Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distance and limit duration to minimize exposure risk.

Arranging in-person meetings at alternate locations is subject to the same recommendation that all participants follow physical distancing.

Staggered work weeks and working from home should be encouraged whenever possible, particularly if physical distancing (two metres) cannot be maintained consistently in the office space.

Staff/contractors should limit the exchange of papers, shared pens and other office equipment. Staff/contractors should avoid handshakes and any other physical contact with others. Staff/contractors should avoid sharing food and snacks. Beverages should not be offered to visitors at this time.

Staff/contractors should limit the use of shared reusable cups, dishware and utensils unless it can be cleaned with a dishwasher.

For the most up-to-date recommendations on dress code, refer to the IPAC document for Administrative Staff.

2. External Visitors To reduce the flow of people in the office, virtual and telephone meetings should be prioritized over in-person visits. External partners and clients conducting business with the office should be provided with alternatives to in-person meetings.

Receiving visitors A record of visitors that have entered the office should be kept Meeting organizer must remind visitors to not come into the office if experiencing any COVID-19-like symptoms as per the below. Signage should also be posted to the same effect

o Fever o Cough: new or worse than usual o Shortness of breath o Diarrhea o Nausea and/or vomiting o Headache o Runny nose/nasal congestion

o Sore throat or painful swallowing o Loss of sense of smell o Loss of appetite o Chills o Muscle aches o Fatigue

At arrival, visitors should perform hand hygiene.



http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/Dress%20Code%20Administrative.pdf

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Alternative solutions to visitors waiting in the office should be considered. Some can include: text message and/or call when visitor is ready to be seen.

Visitors may choose to wear their own mask based on personal preference. Masks are not required and not provided by VCH.

Visitors should maintain physical distancing throughout their visit as much as possible, even when wearing masks.

Throughout the visit, respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and, if applicable, mask, and immediately performing hand hygiene.

Visitors should bring their own equipment and supplies, such as pen, paper and meeting support materials.

Visitors should perform hand hygiene before leaving the office and building.



Elevators and stairwells Physical distancing should be encouraged in elevators. - Elevator occupancy number will vary according to size of the elevator and physical distancing

requirements. The capacity for elevators will be defined by local EOCs in partnership with Public Health and Employee Health.

• Recommendations to consider: Small elevator- 2 people maximum Large elevator- 4 to 6 people maximum Masks can permit increased occupancy

� Action: Place posters to remind of elevator etiquette, physical distancing and place floor layout in the queue line and inside the elevators to guide users.

Encourage staff who are able to use stairwells and maintain physical distance to reduce elevator crowding.

Cleaning and disinfecting administrative office suites and common areas Administrative offices and common areas such as reception desks, lounges, lunch rooms, meeting rooms, hallways and washrooms should be cleaned and disinfected on a regular basis (as defined per local contracts), and when needed.

The frequency and who conducts cleaning activities will be defined by local EOCs and local contracted partners in consultation with Public Health and Employee Health.

All personal belongings should be removed from meeting rooms and other common spaces after use. If clearing objects left by other users, hand hygiene should be performed immediately after.

Layout and flow Recommend using automatic door plates, where available. Where not available and access control is not a concern, consider propping the door open during operating hours to reduce contact.

Hand hygiene stations should be available at all entrances and exits to the office suite and be easily accessible. � Action: Ensure appropriate hand hygiene supplies are in place and are maintained

4

Reception areas and hallways should have visual cues to assist in physical distancing (two metres) and if possible, one way directional flow.

Seats in shared spaces such as waiting rooms, lunch rooms and lounges should be spaced to maintain physical distancing (two metres). - If this is not possible, tape off enough seating to maintain two metres of separation, or consider

staggered breaks or alternate break areas.

Non-essential items (remote control, magazines etc.) should be removed from common areas.

1

COVID-19 Recovery Public Health and Infection Control Key Principles & Safety Plan

For Long Term Care Settings

Updated: 26 May 2020 Please note that VCH is taking the necessary precautions to provide the best possible care in a safe environment for our residents, visitors, staff and medical staff. Everyone needing care, regardless of COVID-19 status, is welcomed at VCH. Please follow Public Health guidelines and Infection Prevention & Control principles when preparing your area of work. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. This guidance document is only to be followed when there is NO outbreak in the home, in the event of an outbreak follow restrictions in accordance with advice and direction from the local Medical Health Officer. Please note: amendments to this document will occur as COVID-19 recovery phases evolve.



Quick Reference: 1. Residents

a. New Residents b. Recommendations for Residents going out c. Daily screening process d. Within the care home

2. Family and Friends (Visitors) a. Virtual Visits b. In-person Visits

3. Staff a. Staff providing direct patient care (e.g., nurses, physicians, allied health and social care staff,

contracted services, contracted therapy services etc.) b. Staff not providing direct patient care (e.g., administrative staff, managers, contracted services etc.)

4. Equipment/Supplies/Environment a. Elevators and stairwells b. Cleaning and disinfecting clinical, administrative and public areas c. Layout and Flow



2

1. Residents

New Residents All new residents undergo screening prior to moving in to any long term care home. - If the person is COVID-19 positive, please contact the local Medical Health Officer to determine

action.

Prior to entering the care home, new residents must perform hand hygiene. - If wearing procedural gloves remove, discard and explain hand hygiene recommendations.

On moving into the care home all residents are screened for COVID-19 including temperature check and are required to undergo 14 days of isolation. - They should ideally move into a single room if available or a semi-private room with curtains drawn

between beds, maintaining at least 2 metres between residents. - In addition to meeting care needs a plan for 1:1, in-person, scheduled and meaningful interactions

with care aids and all allied staff is developed and implemented. - OT/PT assessments may be performed via virtual mechanisms. In-person assessment and

interventions may be considered on a case by case basis when deemed essential. - Support virtual visits with loved ones. - For residents who have having difficulties being in isolation or are unable to adhere to isolation

instructions, please contact the VCH/PHC Response Coordination Group.

Recommendations for going out of care home

A) Going out for medical treatments or procedures at another location (no admission to hospital) Provide resident with freshly laundered clothing prior to leaving the care home. Prior to leaving and on return home, residents should perform hand hygiene. - There is no requirement for residents to wear procedural gloves when going out. If a resident

returns wearing procedural gloves remove and discard prior to hand hygiene.

On return home, perform in-person screening (including a temperature check) and assist the resident change into another set of clothes.

Residents returning home with no clear exposure to a known COVID-19 positive case and without signs or symptoms of COVID-19 are not required to undergo 14 days of isolation.

B) Going for medical treatments or procedures requiring admission to hospital Provide resident with freshly laundered clothing prior to leaving the care home. Prior to leaving and on return home, residents must perform hand hygiene. - There is no requirement for residents to wear procedural gloves when going out. If a resident



On return home, the resident is required to undergo 14 days of isolation. - They should ideally move into a single room, if available or a semi-private room with curtains

drawn between beds, maintaining at least 2 metres between residents. - In addition to meeting care needs a plan for 1:1, in-person, scheduled and meaningful interactions

with care aids and allied staff is developed and implemented. - OT/PT assessments may be performed via virtual mechanisms. In-person assessment and

interventions may be considered on a case by case basis. - Support virtual visits with loved ones. - For residents who have having difficulties being in isolation or are unable to adhere to isolation


https://forms.gle/iCBcJgYi9BAPxfSi8


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C) Going Out for leisure or social activities Provide resident with freshly laundered clothing prior to leaving the care home. Prior to leaving and on return home, residents must perform hand hygiene. - There is no requirement for residents to wear procedural gloves when going out. If a resident



Residents with no clear exposure to a known COVID-19 positive case and without signs or symptoms of COVID-19 are not required to undergo 14 days of isolation.

D) Authorized temporary absence from the care home e.g. Staying with family Provide resident with freshly laundered clothing prior to leaving care home. Prior to leaving and on return home, residents must perform hand hygiene. - There is no requirement for residents to wear procedural gloves when going out. If a resident


On return home, perform in-person screening (including a temperature check) and assist the resident change into another set of clothes..

On return home, the resident is required to undergo 14 days of isolation. - They should ideally move into a single room if available or a semi-private room with curtains drawn

between beds, maintaining at least 2 metres between residents. - Continue routine practices for dishes and laundry and regularly screen for symptoms. - In addition to meeting care needs a plan for 1:1, in-person, scheduled and meaningful interactions

with care aids and allied staff is developed and implemented. - OT/PT assessments may be performed via virtual mechanisms. In-person assessment and

interventions may be considered on a case by case basis. - Support virtual visits with loved ones. - For residents who have having difficulties being in isolation or are unable to adhere to isolation


Daily screening process Residents are screened and assessed for symptoms on an ongoing basis.

• Refer to the screening process provided by the BCCDC. • In the event of an Outbreak in the care home. Screening tools to be provided by the outbreak

response team in coordination with Public Health.

Swab residents with signs or symptoms of COVID-19. - Symptoms include (but are not limited to): fever, new cough or worsening of chronic cough,

difficulty breathing or shortness of breath. - Place on droplet and contact precautions and alert staff.

• If positive, follow the direction of your local Medical Health Officer. • If negative, resident should be evaluated by the care home physician or nurse practitioner

to determine alternative diagnosis and whether further work-up for COVID-19 is required despite negative test.

Only residents positive for COVID-19 or on isolation are to wear a surgical/procedure mask when leaving their room.

Within the care home Engage family and residents in education on physical distancing, infection prevention and control, hand hygiene, respiratory etiquette and maintaining social connection with residents in the care home safely.


http://www.bccdc.ca/Health-Info-Site/Documents/COVID19_LongTermCareAssistedLiving.pdf

4

When accessing common spaces (e.g., dining room, shared activity areas, media lounges, outdoor smoking areas), residents must perform hand hygiene and maintain 2 metres of physical distance or ensure appropriate environmental controls are in place.

Respiratory etiquette must be followed, including cover cough and sneeze and avoid touching the face, mouth, nose and eyes. - For residents who are having difficulties being in isolation or are unable to adhere to isolation

instructions, please contact the VCH/PHC Response Coordination Group for support and advice.

2. Family and Friends (Visitors)

Please note: Any Public Health Orders currently in place supersedes all recommendations below (to view orders, visit http://www.vch.ca/covid-19 and review all Long Term Care documents under “Orders.”) Virtual visits Family/friends should be provided with alternatives to in-person visits, where possible. � Action: Care home to define a process and criteria for virtual visits (priority of residents/conditions,

timing, and storage etc.)

If needed, information on “Guidelines for Cleaning and Disinfection of Tablets” can be accessed here. In-person visits

To reduce risks of COVID-19 for patients, clients, family, residents and staff, virtual visits should be prioritized over in-person visits. Exceptions can be made for compassionate reasons. Please refer to the Guidelines for Visitation during COVID-19.

Public access to care homes must be controlled and staffed to ensure risk mitigation measures can be safely adhered to. - Action: Care home to maintain a list of all visitors (7 days a week, 24 hours a day). - Action: Provide all visitors with an information handout about COVID-19.

Risk mitigation measures for all visitors: 1. All visitors are encouraged to self-assess prior to visiting the care home. If symptomatic

visitors should not visit in person and follow public health guidance. 2. On arrival all visitors are subject to symptom screening, if showing symptoms compatible with

COVID-19 or a recent history of exposure to COVID-19 (within last 14 days) are advised to self-isolate and seek medical advice regarding testing. Offer virtual methods of visiting as an alternative.

3. All visitors will be provided with a surgical/procedure mask that is to be worn for the duration of the visit.

4. Visits can occur in the resident’s room or outdoors in patio or garden spaces.

On arrival, visitors must perform hand hygiene. Procedural gloves must be removed and discarded prior to performing hand hygiene.

Throughout the visit, respiratory etiquette must be followed, including cover cough and sneeze and avoid touching the face, mouth, nose, eyes and masks.

For residents with active or suspected COVID-19: - Visitors must don appropriate PPE supplied by the care home (contingent on accessibility and

availability). - Care home to consult with the local Medical Health Officer prior to visit. - Frontline staff will provide education on how to safely put on and remove PPE.





http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/COVID%2019%20Recovery%20Infection%20Control%20Info%20Sheet%20for%20Patient%20Clients%20Visitors.pdf

5

3. Staff Staff providing direct care (e.g., care aides nurses, physicians, allied health care staff, contracted services, contracted allied health care staff etc.) Please note: Any Public Health Orders currently in place supersedes all recommendations below (to view orders, visit http://www.vch.ca/covid-19 and review all Long Term Care documents under “Orders.”) Staff are encourage to be mindful and plan interactions with other staff members and residents throughout day.

At the beginning of their shift, all staff are to undergo a daily screening questionnaire and temperature check. - If staff have been away from work for more than 14 days, an enhanced screening questionnaire

must be completed 72 hours prior to their first shift. The completed questionnaire should be submitted to their Director of Care or Manager.

� Action: Care home to record staff/medical staff temperatures. � Action: Care home to maintain a list of all staff/medical staff (7 days a week, 24 hours a day). - Management must ensure staff who have a long period of absence are provided an update of

current recommendations see IPAC and Long Term Care Toolkit

All staff are to undergo a second temperature check during their shift. - While there is not prescribed time for when the temperature check is to occur, we suggest half way

through or at the end of the shift. - Action: Care home to record staff/medical staff temperatures.

Recommend continuing controlled access with specific staffed entry points for public access. - Action: Care home to maintain a list of all visitors (7 days a week, 24 hours a day). - Action: Provide all visitors with an information handout about COVID-19.

Staff should not come to work with COVID-19-like symptoms. - If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a



Health.

If staff develop symptoms consistent with COVID-19 while at work, they should don a surgical/procedure mask, complete any essential tasks, notify manager if appropriate, then leave work. Testing is strongly recommended, and timing for return to work will be determined by Public Health.

Staff must practice effective hand hygiene before, during and after each episode or provision of care – cleaning their hands with soap and water or an alcohol-based hand sanitizer

Staff must follow respiratory etiquette, including cover cough and sneeze and avoid touching the face, mouth, nose, eyes and mask. Perform hand hygiene if mask is touched/removed/adjusted.

Staff must follow Dress Code Guidelines for Long-Term Care including designated work clothing and change when going home. Consider showering prior to going home.

Clothing to be removed and laundered. Staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment. Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distancing.

Staff must clean and disinfect their own work space following the IPAC Guidelines. For shared work spaces, staff should clean and disinfect space before and after use.


http://www.vch.ca/Documents/LTC-COVID-Staff-Testing-Assessment.PDF

http://www.vch.ca/Documents/LTCF-COVID-19-Enhanced-Staff-Screening-Questionnaire.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/COVID%2019%20Recovery%20Infection%20Control%20Info%20Sheet%20for%20Patient%20Clients%20Visitors.pdf

http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/Dress%20Code%20LTC.pdf


6

Staff should limit the exchange of papers. If documents must be exchanged, leave them on a clean surface.

Staff should avoid sharing pens and other office equipment. Staff should avoid handshakes and any other physical contact with others. Where feasible, maintain 2 meters of distance between others.

Staff must avoid sharing food and snacks. Staff not providing direct patient care (e.g., administrative staff, contracted services etc.) Please note: Any Public Health Orders currently in place supersedes all recommendations below (to view orders, visit http://www.vch.ca/covid-19 and review all Long Term Care documents under “Orders.”) Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distancing.

Staff should not come to work with COVID-19-like symptoms. - If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a



Health.

If staff develop symptoms consistent with COVID-19 while at work, they should don a surgical/procedure mask, complete any essential tasks, notify manager if appropriate, then leave work. Testing is strongly recommended, and timing for return to work will be determined by Public Health.

Staff must perform frequent hand hygiene. Staff must follow respiratory etiquette, including cover cough and sneeze and avoid touching the face, mouth, nose, and eyes. Perform hand hygiene if mask is touched/removed/adjusted.

Staff must clean and disinfect their own work space following the IPAC Guidelines. Staff should limit the exchange of papers. If documents must be exchanged, leave them on a clean surface.

Staff should avoid sharing pens and other office equipment. Staff should avoid handshakes and any other physical contact with others. Where feasible, maintain 2 meters of distance between others.

Staff must avoid sharing food and snacks. For the most up-to-date PPE recommendations, refer to the IPAC document for Community Settings (includes LTC). - Other considerations: A surgical/procedure mask is not required when preparing meals in the

kitchen. A surgical/procedure mask is required when serving meals in resident care area.


Owners of pets and other animals other than those identified as Certified Guide or Service animals should not be brought into care homes.

Elevators and stairwells Encourage staff who are able to use stairwells while maintaining physical distance reduce elevator crowding.




7

Physical distancing is encouraged in elevators. - Elevator occupancy number will vary according to size of the elevator and physical distancing

requirements. Use of masks may allow for increased occupancy. • Recommendations to consider:

o Small Elevator – 2 people maximum o Large Elevator – 4- 6 people maximum o Post signs outside of elevators with recommended occupancy o Place signage eg footprints on floor of elevator to guide distancing.

Cleaning and disinfecting clinical, administrative and public areas Cleaning clinical areas. - The units within the care home require daily enhanced cleaning. Refer to VCH/PHC’s LTC Enhanced

Cleaning guidance document. - Dedicate equipment and supplies to a single client/resident, where possible; and clean and

disinfect equipment upon removal from room. - When possible, single use equipment and supplies are recommended. - Common areas and high-touch surface areas should be cleaned and disinfected a minimum of twice

a day (6-8 hours following the daily enhanced cleaning), with a focus on high touch points such as seating areas, doors, handrails, light switches, door handles, toilets, taps, handrails, phones, keyboards, and counter tops.




Cleaning Administrative Offices - Follow the routine department practices for cleaning and disinfection.

Cleaning Public Areas - Public areas, such as hallways and stairways, should be cleaned and disinfected on a daily basis, and

when needed.

All staff are recommended to clean and disinfect their own or shared work space following the IPAC Guidelines.

De-clutter and minimize equipment and supplies so effective environmental cleaning can be achieved. Layout and flow Recommend using automatic door plates, where available. Hand hygiene stations should be available and easily accessible at doorway entrances and exits including stairwells. � Action: Ensure appropriate hand hygiene are in place and hand hygiene products are maintained

Staff shared spaces, common areas, shared activity areas, media lounges, outdoor smoking areas and dining room seats should be spaced to maintain a physical distancing. - Shared activities in the same space and activities with shared objects should be avoided. - If staff lounge not large enough to accommodate physical separation, consider staggered breaks or

alternative break areas. - Recommendations to consider:

o All seating should be a minimum of one metre apart (least ideal) to two or more metres apart (most ideal). If this is not possible, tape off enough seating to maintain appropriate distancing.

http://ipac.vch.ca/Documents/COVID-19/COVID-19-LTC-Toolkit/LTC%20Enhanced%20Cleaning%20Guidance.pdf






8

o Please reference VCH/PHC’s Guidance on Physical Distancing in LTC and Assisted Living Facilities for more details.

Products (e.g., creams, lotions) are dedicated to a single user, when possible. Reception area, common areas and hallways should have visual cues to assist in physical distancing (two metres) and if possible, one way directional flow.

Wherever possible, relocation of residents should be minimized.

http://ipac.vch.ca/Documents/COVID-19/COVID-19-LTC-Toolkit/Guidance%20on%20Physical%20Distancing%20in%20LTC-AL.PDF

http://ipac.vch.ca/Documents/COVID-19/COVID-19-LTC-Toolkit/Guidance%20on%20Physical%20Distancing%20in%20LTC-AL.PDF

1


For Community-Based Clinics

Updated: 28 May 2020 Please note that VCH is taking the necessary precautions to provide the best possible care in a safe environment for our patients, residents, visitors, staff and medical staff. Every patient needing care, regardless of COVID-19 status, is welcomed at VCH. Please follow Public Health guidelines and Infection Prevention and Control principles when planning your recovery efforts for Community-based Clinics. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. Please note: amendments to this document will occur as COVID-19 recovery phases evolve. Quick Reference:



a. Staff/Medical Staff providing direct patient care (e.g. nurses, physicians, allied, contracted services etc.)

b. Staff/Medical staff not providing direct patient care (e.g., reception, nursing station, contracted services etc.)

c. Administrative staff, offices, and all other staff not working in direct patient care 4. Equipment/Supplies/Environment

a. Elevators and stairwells b. Cleaning and disinfecting clinical, administrative and public areas c. Layout and flow





2

1. Patient/Clients Virtual visits Virtual visits and telephone-consultation will be offered on a case by case basis determined by the Most Responsible Clinician/Staff. � Action: Define process and criteria for virtual visits (priority of patients/conditions, timing, storage


For cleaning and disinfecting electronic devices, follow the VCH Guidelines for Cleaning and Disinfecting Devices.

In person visits Initial patient and client bookings may need to be limited in order to ensure that patients/clients can follow physical distancing recommendations while accessing services, but may need to be prioritized by urgency. � Action: Local EOC in partnership with Medical Leadership will determine the number of patients to

be seen per Clinic.

Before coming to the clinic… Clinical Designate should connect with Patients/Clients by phone to determine if patients/clients or family members have developed COVID-19-like symptoms and have recent travel history. - Please refer to the Community Screening Standard Operating Procedure (SOP) and the following

script for guidance. - If patient has any COVID-19-like symptoms, the Most Responsible Clinician/Staff should determine

if patient needs to be seen in person or virtual visit is possible.

Patients/clients should be reminded to notify staff of any changes in their health prior to coming to clinic. - The self-assessment tool is available on the BC Centre for Disease Control (BCCDC) website:

https://bc.thrive.health.Please advice patients to follow the recommendations from the self-assessment or to contact 8-1-1 or their primary care provider.

� Action: Ensure that patients have clinic information to notify (e.g. contact information, clinician name, and extension number).

Patients/clients should be reminded that they will undergo screening assessment at many points throughout their clinic visit (e.g.: Phone pre-booking, at the entrance of the facility, at the clinic level, etc.)

When arriving at the clinic… a) Screening at the clinic entry point(s)

Recommend continuing controlled access with specific entry points for public access and staff with security and/or volunteers.

Please refer to the Community Screening SOP, the high-level screening script and the full screening script for guidance. - Note: It is recommended to have a clinical partner at the entrance to support with

questions/concerns requiring clinical expertise. - Note: Based on patient population served, each clinic should determine appropriate barriers for

greeters/security/volunteers; this could include maintaining physical distancing of 2 meters, wearing PPE, or having a physical barrier.

At arrival, patients/clients should perform hand hygiene. � Action: Ensure patients/clients remove procedure gloves, if applicable, and perform hand hygiene.

Gloves should not be put back on. Waste receptacles should be provided for glove disposal. � Action: Place posters at entrances to clinical areas to remind and support visitors of frequent hand



http://shop.healthcarebc.ca/vch/VCHDSTs/D-00-16-30284.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_Appointment%20Reminders_Community.pdf



http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_%20In%20Person%20High%20Level%20Full%20Screening_Community%20based%20Clinics.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_%20In%20Person%20Full%20Screening_Community%20based%20Clinics.pdf

3

hygiene, physical distancing and respiratory hygiene. Only patients/clients with visible and/or self-declared COVID-19-like symptoms, who are not wearing surgical/procedure mask already, will be required to wear a surgical/procedure mask provided by the health authority. - Other considerations: If the Clinic has physical distancing constraints, the use of masks for all

patients and clients, regardless of COVID-19 status may be considered.

If the patient/client is not symptomatic, they can wear their own masks during their visit. b) Screening at destination

At arrival, patients/clients should perform hand hygiene. As part of the check-in process, the patient/client will be asked screening questions. At the entrance of the clinic, greeters/volunteers will conduct screening. Please refer to the Community Screening SOP, the high-level screening script and the full screening script for guidance.

COVID-19-like symptomatic patients require droplet and contact precautions and will be directly placed in a dedicated room and/or waiting room for direct placement of high risk/COVID-19-like symptomatic patients/clients.

During clinic stay… Throughout the visit, respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and, if applicable, mask. - Waste receptacles should be provided for respiratory etiquette.

Throughout the visit, patients/clients should perform hand hygiene. Follow Point-of-Care Risk Assessment as per Infection Prevention and Control Recommendations. - If patient/client cannot effectively be screened (e.g. dementia), staff should use a Point-of-Care Risk


COVID-19-like symptomatic patients require droplet and contact precautions for staff. If possible, patients/clients should maintain physical distancing throughout their visit. After clinic visit… Patients/clients should perform hand hygiene before leaving the clinic and facility/building. Patients/clients with COVID-19-like symptoms that were offered a surgical/procedure mask, should continue to wear the mask until they arrive home.

2. Family/Visitors/Support Family, visitors and support should be limited to 1 per patient. Exceptions can be made for birth, death, compassionate reasons, and pediatrics. Please refer to the Guidelines for Visitation during COVID-19.

Family/visitor/support who present with COVID-19-like visible symptoms should not be permitted to enter the facility for the safety of patients and staff.

Follow “patient/client guidelines” above.

3. Personnel/Staff/Medical Staff Staff/Medical Staff providing direct patient care (e.g. nurses, physicians, allied, contracted services etc.) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace








4




Health.



Staff/Medical staff should consider designated work clothing and change when going home. A clean area should be setup to allow storage of clean clothing. Consider showering prior to going home. Clothing to be laundered should be removed daily to prevent accumulation.

Staff/Medical staff where possible should follow cohort starring or be scheduled together in teams or groupings to minimize the interaction.

Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment.

Each clinic should identify a dedicated examination room and waiting room for direct placement of high risk/COVID-19-like symptomatic patients/clients.

If a patient with COVID-19-like symptoms must be seen in the clinic, Staff/Medical staff should place the appointment at the end of the day if possible. If not possible (e.g. drop in visits) patients/client should be placed in the dedicated examination room and/or waiting room for direct placement of high risk/COVID-19-like symptomatic patients/clients. - Staff should clean and disinfect high touch points and anything in the room that was in contact with

the client (e.g. blood pressure cuffs) using appropriate disinfectant wipes, following VCH Cleaning and Disinfecting Guidelines.

- If possible, the examination room should be closed until terminal clean can be performed. If the examination room cannot be closed and terminal clean cannot be performed, Staff/Medical Staff should clean and disinfect high touch points using appropriate disinfectant wipes, following VCH Cleaning and Disinfecting Guidelines, and the examination room/waiting room should be terminally cleaned at the end of the day.


Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distance. Safety huddles should still occur to share pertinent information to stay at work safely.

Staff/Medical staff should limit the exchange of papers, shared pens and other office equipment. Staff/Medical staff should avoid handshakes and any other physical contact with others in the workplace. Where feasible, maintain 2 meters of distance between others.

Staff/Medical staff should avoid sharing food and snacks. For the most up-to-date PPE recommendations, refer to the IPAC document for the Community Setting. Staff/Medical Staff should follow the most up-to-date Community dress code. Staff/Medical staff not providing direct patient care (e.g. reception) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace

Staff/Medical staff should not come to work with COVID-19-like symptoms.






http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/Dress%20Code%20Community.pdf

5

- If staff/medical staff develop symptoms consistent with COVID-19 while at work, they should don a surgical/procedure mask, complete any essential tasks, notify manager if appropriate, then leave work.


Health. Staff/Medical staff must perform frequent hand hygiene. Respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose, eyes and if applicable, mask.


Team meetings and in-person interactions should be replaced with virtual options, as much as possible. If not possible, maintain physical distancing. Safety huddles should still occur to share pertinent information to stay at work safely.

Staff/Medical staff should limit the exchange of papers, shared pens and other office equipment. Staff/Medical staff should avoid handshakes and any other physical contact with others in the workplace. Where feasible, maintain 2 meters of distance from others.

Staff/Medical staff should avoid sharing food and snacks. For the most up-to-date PPE recommendations, refer to the IPAC document for the Community Setting. Administrative staff, offices, and all other staff not working in direct patient care Shared workstations should be minimized where possible to reduce cross-interaction with surfaces. Follow “Staff/Medical staff not providing direct patient care” guidelines above.



Elevators and stairwells Physical distancing should be encouraged in elevators. - Elevator occupancy number will vary according to size of the elevator and physical distancing


• Recommendations to consider: Small elevator- 2 people maximum Large elevator- 4 to 6 people maximum Masks can permit increased occupancy

- If possible, an elevator monitor is recommended to assist and direct accordingly. � Action: Place posters to remind of elevator etiquette, physical distancing and place floor layout in

the queue line and inside the elevators to guide users.

Encourage staff to use stairwells and maintain physical distancing to reduce elevator crowding. Cleaning and disinfecting clinical, administrative and public areas Cleaning clinical areas: - During the examination, any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard)



6

should be cleaned and disinfected by the direct provider, using the routine department practices for cleaning and disinfecting.

o When possible, single use equipment and supplies are recommended. o Equipment (e.g. vital sign machine) used in the dedicated room and/or waiting room for

direct placement of high risk/COVID-19-like symptomatic patients/clients, should not be shared with non COVID-19 patients.

- Common areas and high-touch surface areas should be cleaned and disinfected at least twice a day, with a focus on high touch points such as reception counters, seating areas (including clinic room seats and armrests), doors, handrails, light switches, door handles, toilets, taps, handrails, phones, keyboards, and counter tops. The frequency and who conducts cleaning activities will be defined by local EOCs in partnership with Public Health and Infection Prevention and Control.

- For cleaning instructions, disinfecting and frequency of equipment, refer to the Infection Prevention and Control Master Equipment Cleaning and Disinfection Manual and/or refer to the facilities manual for specific equipment/supplies cleaning recommendations.

Cleaning other clinical areas: - Other clinical areas such as lunch rooms, lounges, and offices on the unit should be cleaned and

disinfected twice a day, and when needed.

Cleaning Administrative Offices: - Administrative Offices should be cleaned and disinfected twice a day, and when needed.

Cleaning Public Areas: - Public areas, such as hallways and stairways, should be cleaned and disinfected twice a day, and

when needed.

All staff are recommended to clean and disinfect their own or shared work space following the IPAC Guidelines, and to de-clutter and minimize equipment and supplies so effective environmental cleaning can be achieved.

Layout and flow Recommend using automatic door plates, where available. Hand hygiene stations should be available and easily accessible at all doorway entrances and exits. � Action: Ensure appropriate hand hygiene stations are in place and hand hygiene products are

maintained.

Staff shared spaces, waiting rooms, cafeterias, coffee shops and common areas (lounges) seats should be spaced to maintain physical distancing. - If staff lounge is not large enough to accommodate spatial separation, consider staggered start

times, staggered breaks or alternate break areas. - Recommendation to consider:

o All seating should be two meters apart. If this is not possible, tape off enough seating to maintain two meters separation.

Non-essential items (remote control, magazines, toys, etc.) should be removed from waiting and gathering areas. Refer to De-clutter Audit Tool.

Products (e.g. creams, lotions) are dedicated to a single user when possible. Alternative solutions to waiting in the office should be considered. Some can include: text message and/or call when patient is ready to be seen.

Reception area and clinic hallways should have visual cues to guide physical distancing (2 meters) and if possible, one-way directional flow.






1


For Community-Based Home Visits and Outreach

Updated: 26 May 2020 Please note that VCH is taking the necessary precautions to provide the best possible care in a safe environment for our patients, residents, visitors, staff and medical staff. Every patient needing care, regardless of COVID-19 status, is welcomed at VCH. Please follow Public Health guidelines and Infection Prevention and Control principles when planning your recovery efforts for Community-based Home Visits and Outreach. For more information, please visit http://www.vch.ca/covid-19 or the IPAC website at http://ipac.vch.ca/Pages/Emerging-Issues.aspx. Please note: amendments to this document will occur as COVID-19 recovery phases evolve. Quick Reference:



a. Staff/Medical Staff providing direct patient care (e.g., nurses, physicians, allied, contracted services etc.)

b. Staff/Medical Staff not providing direct patient care (e.g., reception, nursing station, contracted services etc.)

c. Staff/Medical staff not providing direct patient care (e.g. reception, nursing station, contracted services etc.)

4. Equipment/Supplies/Environment a. Cleaning and disinfecting equipment used during home or outreach visit b. Cleaning electronic devices c. Layout and flow





2

1. Patient/Clients Virtual visits Virtual visits and telephone-consultation will be offered on a case by case basis determined by the Most Responsible Clinician/Staff. � Action: Define process and criteria for virtual visits (priority of patients/conditions, timing, storage


In person visits Where virtual visits are not appropriate, home visits and outreach visits can be conducted with appropriate screening procedures and use of Personal protective equipment (PPE) to protect clinician/staff. For the most up-to-date PPE recommendations, refer to the IPAC document for the Community Setting.

Preparing for home or outreach visit… Clinician/Staff should contact patient/client by phone for screening prior to home or outreach visit. - If the call goes to voicemail, the clinician/staff will leave a message advising the client to callback

prior to their next planned visit. - If the patient/client does not call back, the clinician/staff:

• Will reach out to internal or external team members, such as client’s family physician, as needed and determine patent/client’s health status and urgency for visit.

• May defer the home/outreach/on site visit until they are able to reach the patient/client • May complete screen at time of visit.

- If the patient/client does not have a phone, screening can be done at time of visit. - Please refer to the Community Screening Standard Operating Procedure (SOP) and the following

script for guidance.

Patients/clients should be asked to call the community health center to notify staff of any changes in their health prior to home or outreach visit. � Action: Ensure that patients have clinic information to notify (e.g. contact information, clinician

name, and extension number)

Patients/clients should be reminded that they will undergo screening assessment at different points throughout the home or outreach visit (e.g.: Phone pre-booking, start of the home visit)

Preparing for home or outreach visit… Clinician/Staff should contact patient/client by phone for screening prior to home or outreach visit.

During home or outreach visit… Prior to commencing visit, perform screening at a two meter distance using appropriate PPE. For the most up-to-date PPE recommendations, refer to the IPAC document for the Community Setting. - If client cannot effectively be screened (e.g. dementia), staff should use a Point-of-Care Risk


COVID-19-like symptomatic patients/clients require droplet and contact precautions. - Please refer to the Community Screening Standard Operating Procedure (SOP) for guidance. - Note: Screening questions should be directed at the client and anyone else present in the home

environment. - Throughout the visit, other individuals in the home environment are asked to maintain a two

meters distance.

Patients/clients should perform hand hygiene at the start of the visit. Throughout the visit, respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose and eyes.




http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_%20Appointment%20Reminders_Home%20visits%20Outreach.pdf





3

After home or outreach visit… Staff should find a safe place to doff their PPE. - Doffed PPE is discarded in the patient/client’s home waste streams.

Staff should clean and disinfect reusable equipment that was used during the visit. Staff perform hand hygiene upon leaving the home or at the close of the outreach visit.

2. Family/Visitors/Support Virtual visits and telephone-consultation will be offered on a case by case basis determined by the Most Responsible Clinician/Staff. � Action: Define process and criteria for virtual visits (priority of patients/conditions, timing, storage


In person visits Where virtual visits are not appropriate, home visits and outreach visits can be conducted with appropriate screening procedures and use of Personal protective equipment (PPE) to protect clinician/staff. For the most up-to-date PPE recommendations, refer to the IPAC document for the Community Setting.


Staff/Medical Staff providing direct patient care (e.g. nurses, physicians, allied, contracted services etc.) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace




Health.



Staff/Medical staff should avoid handshakes and any other physical contact with others in the workplace. Where feasible, maintain 2 meters of distance between others.

Staff/Medical staff should avoid sharing food and snacks. Staff/Medical Staff should follow the most up-to-date PPE recommendations for the Community Setting.

Staff/Medical Staff should follow the most up-to-date Community dress code. Staff/Medical staff not providing direct patient care (e.g. reception) Personnel should be minimized through the transition and where feasible to reduce the number of interactions in the workplace





http://ipac.vch.ca/Documents/COVID-19/Dress%20Codes%20and%20PPE/Dress%20Code%20Community.pdf

4




Health.

Staff/Medical staff must perform frequent hand hygiene. Respiratory etiquette should be followed, such as coughing and sneezing into the elbow, avoid touching the face, mouth, nose and eyes.


Staff/Medical staff should avoid handshakes and any other physical contact with others in the workplace. Where feasible, maintain 2 meters of distance between others.

Staff/Medical staff should avoid sharing food and snacks. For the most up-to-date PPE recommendations for the Community Setting.

4. Equipment/Supplies/Environment

Cleaning and disinfecting equipment used during home or outreach visit During the examination, any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected by the direct provider, using the routine department practices for cleaning and disinfecting. - When possible, single use equipment and supplies are recommended.

Work surface areas should be cleaned and disinfected prior to use. - For cleaning instructions, disinfecting and frequency of equipment, refer to the Infection

Prevention and Control Master Equipment Cleaning and Disinfection Manual.

Cleaning Electronic Devices For cleaning and disinfecting electronic devices, follow the VCH Guidelines for Cleaning and Disinfecting Devices.

Layout and flow For home and outreach visits it is recommended to follow a clean to dirty pathway. - Note: If possible, staff should place the appointment at the end of the day if possible for

patient/clients with COVID-19-like symptoms.

Products (e.g. creams, lotions) are dedicated to a single user when possible.








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APPENDIX B – IPAC COVID-19 Recovery Checklists

Acute Care Settings: Infection Prevention and Control COVID-19 Recovery Checklist

Updated: 28 May 2020

Instructions

1. Assemble an assessment team that includes department or unit leadership and representation from the Joint Occupational Health and Safety Committee (JOHSC). For sites without a JOHSC, the applicable worker representative should be part of the assessment team.

2. Review the Acute Settings Key Principles and Safety Plan to ensure that your department or unit has implemented all the Employee Safety, Infection Control and Public Health recommendations. Please add any additional information that would be essential for your team.

3. Perform visual inspection of the department or unit.

4. Review checklist and for each item check the correspondent compliance level: Yes, No, N/A.

o If applicable, determine the remediation plan. o Infection Control requirements are marked with a red star (*) o WorkSafeBC requirements are marked with a green star (*)

5. Remediate issues that can be easily addressed.

6. Calculate compliance score and additional comments section.

o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the department or unit is prepared from an Employee Safety, Infection Control and Public Health standpoint. Ultimately, this decision must made by the assessment team.

7. Review outstanding issues/concerns and prepare the department/unit for service recovery.

8. Communicate your safety plan to your team and post in an area that is easily accessible. The safety plan must be posted as per the PHO order.

9. Send the completed checklist to your JOHSC for review and inclusion in the JOHSC minutes. 10. A copy of the complete checklist must be sent to [email protected] to be stored electronically.

Site:

Department:

Date:

Questions? Please consult with your IPAC practitioner or local safety advisor.

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Acute/Public%20Health%20and%20Infection%20Control%20Key%20Principles_Acute.pdf

mailto:[email protected]?subject=Recovery%20Checklist


2

Element Compliance

Remediation Plan Yes No N/A

1) Policies and Procedures

1.1 (*) The facility’s capacity to accommodate appropriate patient flow is assessed on a regular basis. ☐ ☐ ☐

1.2 (*)(*)

1.2.1 Environmental Services (EVS) contract in place, identifying: ☐ ☐ ☐

1.2.2 Routine cleaning and disinfection procedures. ☐ ☐ ☐

1.2.3 Frequency of cleaning. ☐ ☐ ☐

1.2.4 List of clinical and non-clinical areas EVS will clean and disinfect. ☐ ☐ ☐

1.2.5 Terminal cleaning of rooms suspected of contamination from symptomatic patients ☐ ☐ ☐

1.3 (*)

1.3.1 The following recommendations for medical and non-medical staff are in place, including: ☐ ☐ ☐

1.3.2 (*) Not coming to work sick. ☐ ☐ ☐

1.3.3 Staggered start times. ☐ ☐ ☐

1.3.4 Staggered break times. ☐ ☐ ☐ 1.3.5

(*) No sharing of food. ☐ ☐ ☐

1.4 (*)(*)

1.4.1 There is a process in place to support physician’s virtual visit or telephone consultation (if appropriate). ☐ ☐ ☐

1.4.2

There is a process in place for MOA or clerk to pre-screen patients for COVID-like symptoms (recommended script). Patients will also be screened: • Upon arrival at the entrance of the facility • At the reception

☐ ☐ ☐

1.4.3

Points of entry have controlled access in place to facilitate: 1. Screening for symptoms 2. Providing surgical/procedure masks if required 3. Patient flow (w/ physical distancing) 4. Hand hygiene reminder

☐ ☐ ☐

1.4.4 Reception and other staff where feasible can maintain a 2 meter distance with clients/patients, have a physical barrier or wear PPE.

☐ ☐ ☐

1.5 There is a process in place to screen patients for COVID-like symptoms upon arrival at the clinic (recommended script).

☐ ☐ ☐

1.6 (*)(*) Designated isolation/private room is available for direct placement of symptomatic/high-risk patients. ☐ ☐ ☐

1.7 (*)(*) There is a process in place to take patients presenting with COVID-like symptoms to the designated examination/isolation room and/or waiting area.

☐ ☐ ☐

1.8 (*)(*)

There is a process in place that determines that the terminal clean of symptomatic/high risk patient’s examination room will be done upon discharge. Refer to VCH’s Cleaning and Disinfecting Guidelines.

☐ ☐ ☐

1.9 (*) There is a process in place for booking high-risk patients at the end of the day, if possible. ☐ ☐ ☐

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Acute/Script_%20Appointment%20Reminders_Acute%20Care.pdf








3

1.10 (*)(*)

1.10.1 There is a process in place to provide surgical/procedure masks to individuals that present with COVID-19-like symptoms.

☐ ☐ ☐

1.10.2 Personal protective equipment (PPE) is available for staff as outlined in the PPE Recommendations for Acute. ☐ ☐ ☐

1.11 (*)(*) Alcohol-based hand rub (ABHR) is available at entrance and exit from clinical and non-clinical areas. ☐ ☐ ☐

1.12 (*)(*)

1.12.1 Visual alerts (e.g., signs, posters) indicating hand hygiene, respiratory etiquette and physical distancing are present throughout clinical and non-clinical areas.

☐ ☐ ☐

1.12.2 Clear physical distancing indicators are in place throughout clinical and non-clinical areas, i.e. elevators, waiting rooms, staff rooms etc.

☐ ☐ ☐

1.12.2 Stairwell access made available to staff. ☐ ☐ ☐

1.13 A process in place to provide guidance/update to elevator monitors with elevator capacity. ☐ ☒ ☐

1.14 Medical and non-medical equipment (e.g. clipboards) are not accessible by patients/visitors/families. ☐ ☐ ☐

1.15 (*)(*) Non-clinical areas (e.g., waiting area) have been de-cluttered removing non-essential items (remote control, magazines, toys, etc.) Refer to De-clutter Audit Tool.

☐ ☐ ☐

1.16 (*) Examination and clinic rooms have minimal supplies and equipment. ☐ ☐ ☐

2) Education

2.1 (*) Medical and non-medical staff have received education on appropriate use of personal protective equipment, based on guidelines.

☐ ☐ ☐

2.2 (*) Medical and non-medical staff training and education has been documented. Please refer to the LearningHub Modules for online education resources.

☐ ☐ ☐

2.3 (*)(*) Medical and non-medical staff are aware of appropriate donning and doffing procedures. ☐ ☐ ☐

2.4 (*) Point-of-care Risk Assessment has been reviewed with staff providing direct patient care. ☐ ☐ ☐

2.5 (*) Medical and non-medical staff have been provided information relating to COVID-19 and the measures in place to ensure safety within the facility

☐ ☐ ☐

3) Routine practices

3.1 (*)(*) PPE supplies are readily available and accessible in appropriate sizes. ☐ ☐ ☐

3.2 (*) ABHR are located at point of care (clinical areas). Soap, water, and paper towel is available for use at hand washing stations

☐ ☐ ☐

3.3 Single use, disposable equipment used if possible. ☐ ☐ ☐

3.4

Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment. Specifically the number of treatment bays used by an individual physician should be limited/designated per area.

☐ ☐ ☐

4) Environment

4.1 (*)(*) High touch points (e.g. side tables, side rails, chairs, hand washing sinks, medication carts, charting desks, touch ☐ ☐ ☐




https://learninghub.phsa.ca/Courses/22981/vch-covid-19-education-curriculum


http://ipac.vch.ca/Documents/Acute%20Resource%20manual/Donning%20PPE.pdf

http://ipac.vch.ca/Documents/Acute%20Resource%20manual/Doffing%20PPE.pdf



4

screens, white boards, outside of sharps containers etc.) in common areas are cleaned and disinfected at least 2x per day (refer to the Cleaning and Disinfecting Guidelines).

4.2 (*) Single-use covers (e.g., paper table covers) are discarded after each patient. ☐ ☐ ☐

4.3 (*) A schedule is in place for cleaning and disinfecting surfaces/bins/shelves that are not routinely serviced by EVS or staff.

☐ ☐ ☐

4.4 (*) Staff lounges are de-cluttered and set up to accommodate physical distancing. ☐ ☐ ☐

4.5 (*) Staff lounges and work spaces are equipped with disinfecting wipes for medical and non-medical staff to clean and disinfect.

☐ ☐ ☐

4.6 Products (e.g. creams, lotions) are dedicated to the user. ☐ ☐ ☐

4.7 (*)

Any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected using the routine department practices for cleaning and disinfecting between patients.

☐ ☐ ☐

4.8 Containers that are used for product storage are cleaned, disinfected and dried in-between use. ☐ ☐ ☐

4.9 ABHR are available at computer/phone stations. ☐ ☐ ☐

4.10 (*) Staff have access to change rooms and showers for changing to dedicated work clothing ☐ ☐ ☐

Compliance Score

Total number of “Yes” Compliance Score: ________________ % 𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 (𝐶𝐶𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 𝑠𝑠𝑐𝑐𝑐𝑐𝑠𝑠𝑐𝑐) =

𝑇𝑇𝑐𝑐𝑇𝑇𝑐𝑐𝑐𝑐 𝑐𝑐𝑛𝑛𝑐𝑐𝑛𝑛𝑐𝑐𝑠𝑠 𝑐𝑐𝑜𝑜 "𝑌𝑌𝑐𝑐𝑠𝑠"𝑇𝑇𝑐𝑐𝑇𝑇𝑐𝑐𝑐𝑐 𝑐𝑐𝑛𝑛𝑐𝑐𝑛𝑛𝑐𝑐𝑠𝑠 𝑐𝑐𝑜𝑜 Yes: and 𝑁𝑁𝑐𝑐" × 100

Total number of “No”

Total number of items (Yes + No’s, exclude N/A)




5

Feedback on compliance/additional comments:

Decision for recovery:

1

Ambulatory Care Settings: Infection Prevention and Control COVID-19 Recovery Checklist


Instructions

1. Assemble an assessment team that includes department or site leadership and representation from the Joint Occupational Health and Safety Committee (JOHSC). For sites without a JOHSC, the applicable worker representative should be part of the assessment team.

2. Review the Ambulatory Care Key Principles and Safety Plan to ensure that your department or site has implemented all the Employee Safety, Infection Control and Public Health recommendations. Please add any additional information that would be essential for your team.

3. Perform visual inspection of the department or site.





o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the department or site is prepared from an Employee Safety, Infection Control and Public Health standpoint. Ultimately, this decision must made by the assessment team.

7. Review outstanding issues/concerns and prepare the department or site for service recovery.



Facility/Site:

Date:


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Pulbic%20Health%20and%20Infection%20Control%20Key%20Principles_Ambulatory.pdf


Ambulatory Care: Infection Prevention and Control COVID-19 Recovery Checklist

2

Element Compliance




1.2 (*)(*)


1.2.2 Routine cleaning and disinfection procedures. ☐ ☐ ☐ 1.2.3 Frequency of cleaning. ☐ ☐ ☐



1.3 (*)



1.3.3 Staggered start times. ☐ ☐ ☐ 1.3.4 Staggered break times. ☐ ☐ ☐ 1.3.5


1.4 (*)(*)

1.4.1 There is a process in place for physician’s virtual visit or telephone consultation. ☐ ☐ ☐

1.4.2

There is a process in place for MOA or clerk to pre-screen patients requiring an appointment to the ambulatory clinic for COVID-like symptoms. Please refer to the following script. Patients will also be screened: • Upon arrival at the entrance of the facility. Please

refer to the following script. • At the clinic reception. Please refer to the following

script.

☐ ☐ ☐

1.4.3

Points of entry have controlled access in place to facilitate: 1. Screening for symptoms 2. Providing surgical/procedure masks if required 3. Patient flow (with physical distancing) 4. Performing hand hygiene

☐ ☐ ☐

1.4.4 Reception and other staff where feasible can maintain a 2 meter distance with clients/patients, have a physical barrier or wear PPE.

☐ ☐ ☐

1.5 There is a process in place to screen patients for COVID-like symptoms upon arrival at the clinic. ☐ ☐ ☐

1.6 (*)(*) Designated isolation/private room is available for direct placement of symptomatic/high-risk patients. ☐ ☐ ☐

1.7 (*)(*) There is a process in place to take patients presenting with COVID-like symptoms to the designated examination/isolation room and/or waiting area.

☐ ☐ ☐

1.8 (*)

There is a process in place that determines that the terminal clean of symptomatic/high risk patient’s examination room will be done upon discharge. Refer to VCH’s Cleaning and Disinfecting Guidelines.

☐ ☐ ☐

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20Appointment%20Reminders_Ambulatory.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20In%20Person%20Screening%20at%20Site%20Entry%20Points_Ambulatory.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Ambulatory/Script_%20In%20Person%20Screening%20at%20Clinic%20Reception_Ambulatory.pdf



3

Element Compliance Remediation Plan

Yes No N/A


1.10 (*)(*)


☐ ☐ ☐

1.10.2 Personal protective equipment (PPE) is available for staff as outlined in the PPE Recommendations for Ambulatory Care Settings.

☐ ☐ ☐

1.11 (*) Alcohol-based hand rub (ABHR) is available at entrance and exit from clinical and non-clinical areas. ☐ ☐ ☐

1.12 (*)(*)


☐ ☐ ☐

1.12.2 Clear physical distancing indicators are in place throughout clinical and non-clinical areas, i.e. elevators, waiting rooms, staffrooms etc.

☐ ☐ ☐


1.13 A process in place to provide guidance/update to elevator monitors with elevator capacity. ☐ ☐ ☐


1.15 (*)

Non-clinical areas (e.g., waiting area) have been de-cluttered removing non-essential items (remote control, magazines, toys, etc.) Refer to De-clutter Audit Tool.

☐ ☐ ☐


2) Education


☐ ☐ ☐

2.2 (*) Medical and non-medical staff training and education has been documented. Please refer to the LearningHub Modules for online education resources.

☐ ☐ ☐




☐ ☐ ☐




☐ ☐ ☐

3.3 Single use, disposable equipment used if possible. ☐ ☐ ☐ 3.4 Staff/Medical staff should avoid unnecessary travel ☐ ☐ ☐











4

between rooms/areas for assessment and/or treatment. Specifically the number of treatment bays used by an individual physician should be limited/designated per clinic.

4) Environment

4.1 (*)(*) High touch points (e.g. side tables, side rails, chairs) in patient care area are cleaned and disinfected between clients.

☐ ☐ ☐



☐ ☐ ☐



☐ ☐ ☐


4.7 (*)

Any medical/clinical equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected using the routine department practices for cleaning and disinfecting between patients.

☐ ☐ ☐



4.10 (*) Staff have access to change rooms for changing to dedicated work clothing ☐ ☐ ☐

Compliance Score

Total number of “Yes” Compliance Score: % 𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 (𝐶𝐶𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 𝑠𝑠𝑐𝑐𝑐𝑐𝑠𝑠𝑐𝑐) =



Total number of items (“Yes” + “No”, exclude

“N/A”)


5



Stand-Alone Administrative Offices: Infection Prevention and Control COVID-19 Recovery Checklist


To be completed by the Office Manager or delegate. Please note: amendments to this document will occur as COVID-19 recovery phases evolve. Instructions 1. Review the COVID-19 Recovery Public Health and Infection Control Key Principles & Safety Plan for Stand-Alone

Administrative Offices. 2. Perform visual inspection of the office suite. 3. Review checklist and for each item check the correspondent compliance level: Yes, No, N/A.

o If applicable, determine the remediation plan. o Mandatory elements are marked with a red star (*) o WorkSafeBC required elements are marked with green star (*)



o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the office suite is ready to open from an Infection Prevention and Control lens. Ultimately, this decision must made by the Office Manager.

6. Review outstanding issues/concerns and prepare the clinic for service recovery. o If need extra support, consult with Employee Health for further guidance.

Site: Date:

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Administrative%20Areas/Key%20Principles%20and%20Safety%20Plan%20_%20Standalone%20Administrative.pdf

http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Administrative%20Areas/Key%20Principles%20and%20Safety%20Plan%20_%20Standalone%20Administrative.pdf

mailto:[email protected]?subject=Recovery%20Support

Administrative Offices: Infection Prevention and Control COVID-19 Recovery Checklist

2

Element Compliance



1.1 The facility’s capacity to accommodate appropriate flow of people is assessed on a regular basis. ☐ ☐ ☐

1.2 (*)(*)


1.2.2 Routine cleaning and disinfection procedures. ☐ ☐ ☐ 1.2.3 Frequency of cleaning. ☐ ☐ ☐ 1.2.4 List of areas EVS will clean and disinfect. ☐ ☐ ☐

1.3 (*)

1.3.1 The following recommendations for staff and contractors are in place, including: ☐ ☐ ☐

1.3.2 Not coming to work sick. ☐ ☐ ☐ 1.3.3 Staggered start times. ☐ ☐ ☐ 1.3.4 Staggered break times. ☐ ☐ ☐ 1.3.5 Staggered work week or working from home. ☐ ☐ ☐ 1.3.6 No sharing of food. ☐ ☐ ☐

1.4 (*) (*)

1.4.1 There is a process in place for virtual or telephone meetings. ☐ ☐ ☐

1.4.2 There is a process in place for meeting organizers to remind visitors to not come into the office if experiencing any COVID-19-like symptoms.

☐ ☐ ☐

1.4.3 Reception and other staff where feasible can maintain a 2 metre distance with visitors. ☐ ☐ ☐

2) Environment

2.1 (*) (*) Alcohol-based hand rub (ABHR) is available at entrance and exit from office suite. ☐ ☐ ☐

2.2 (*)(*)

2.2.1 Visual alerts (e.g., signs, posters) indicating hand hygiene, respiratory etiquette and physical distancing are present in the office suite.

☐ ☐ ☐

2.2.2 Clear physical distancing indicators are in place in common areas, i.e. elevators, waiting rooms, staffrooms etc.

☐ ☐ ☐


2.3 (*) (*) Common areas (e.g., waiting area) have been de-cluttered removing non-essential items (remote control, magazines, etc.)

☐ ☐ ☐

2.4 (*) Office spaces have minimal supplies and equipment. ☐ ☐ ☐

3) Education

3.1 (*) Staff have been provided information relating to COVID-19 and the measures in place to ensure safety within the facility

☐ ☐ ☐

Administrative Offices: Infection Prevention and Control COVID-19 Recovery Checklist

3

Compliance Score





“N/A”)



Long Term Care Settings: Infection Prevention and Control COVID-19 Recovery Checklist


Instructions

1. Assemble an assessment team that includes site leadership and representation from the Joint Occupational Health and Safety Committee (JOHSC). For sites without a JOHSC, the applicable worker representative should be part of the assessment team.

2. Review the Long-Term Care Settings Key Principles and Safety Plan to ensure that your site has implemented all the Employee Safety, Infection Control and Public Health recommendations. Please add any additional information that would be essential for your team.

3. Perform visual inspection of the site.





o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the site is prepared from an Employee Safety, Infection Control and Public Health standpoint. Ultimately, this decision must made by the assessment team.

7. Review outstanding issues/concerns and identify remediation requirements.



Please note: Any Public Health Orders currently in place supersedes all recommendations below (to view orders, visit http://www.vch.ca/covid-19 and review all Long Term Care documents under “Orders.”)

Care Home:

Date:


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/LTC/Public%20Health%20and%20Infection%20Control%20Key%20Principles_LTC.pdf



Long Term Care: Infection Prevention and Control COVID-19 Recovery Checklist

2

Element Completed?



1.1 (*) The care home has a procedure in place to keep up to date on the current Public Health Order. ☐ ☐ ☐

1.2 (*)(*)

1.2.1 Environmental Services (EVS) process in place, identifying: ☐ ☐ ☐ 1.2.2 Routine cleaning and disinfection procedures. ☐ ☐ ☐ 1.2.3 Frequency of cleaning. ☐ ☐ ☐

1.2.4 List of clinical and non-clinical areas EVS will clean disinfect. ☐ ☐ ☐


1.3 (*)

1.3.1 The following recommendations for all care staff are in place, including: ☐ ☐ ☐




1.4 (*)

1.4.1 There is a process in place to screen all care staff prior to starting their shift (including a daily screening questionnaire and temperature check).

☐ ☐ ☐

1.4.2 There is a process in place to take all care staff’s temperatures twice daily. ☐ ☐ ☐

1.4.3 There is a process in place to screen any care staff who have been away from work for more than 14 days using the enhanced screening questionnaire.

☐ ☐ ☐

1.4.4 There is a process in place, should any care staff develop COVID-19 symptoms while at work. ☐ ☐ ☐

1.4.5 (*)

There is a process in place to track all care staff coming into the care home. ☐ ☐ ☐

1.5 (*)

1.5.1 There is a process in place to pre-screen newly admitted clients/residents. ☐ ☐ ☐

1.5.2 There is a process in place to screen clients/residents who go offsite for symptoms. ☐ ☐ ☐

1.5.3 There is a process in place to conduct daily symptom screenings for all clients/residents. ☐ ☐ ☐

1.5.4 (*)

Points of entry have controlled access in place to facilitate: 1. Screening for symptoms (e.g., temperature check) 2. Patient flow (w/ physical distancing) 3. Hand hygiene and respiratory etiquette reminder

☐ ☐ ☐

1.6 (*)

1.6.1 There is a process in place to ensure that all newly admitted clients/residents undergo 14 days of isolation. ☐ ☐ ☐

1.6.2

There is a process in place to ensure that clients/residents returning from a hospital admission or extended period away from the care home undergo 14 days of isolation, if appropriate.

☐ ☐ ☐

1.7 There is a process in place and criteria developed to support virtual visits. ☐ ☐ ☐

1.8 1.8.1 There is a process in place to safely support clients/residents conduct in-person visits with family/visitors/supports, if appropriate. Refer to the VCH/PHC LTC Facility Visitor policy.

☐ ☐ ☐

http://www.vch.ca/Documents/LTC-COVID-Staff-Testing-Assessment.PDF

http://www.vch.ca/Documents/LTCF-COVID-19-Enhanced-Staff-Screening-Questionnaire.pdf

http://www.vch.ca/Documents/LTC-COVID-19-Visitor-Policy.pdf


3

1.8.2 (*)

There is a process in place to track all visitors coming into the care home. ☐ ☐ ☐

1.9 (*)

1.9.1 There is a process in place to provide surgical/procedure masks to any clients/residents with COVID-19-like symptoms or on isolation when leaving their room.

☐ ☐ ☐

1.9.2 (*)

Personal protective equipment (PPE) is available for staff as outlined in the PPE Recommendations for Community Settings (includes LTC).

☐ ☐ ☐

1.10 (*)(*) Alcohol-based hand rub (ABHR) is available and easily accessible at doorway entrances and exits. ☐ ☐ ☐

1.11 (*) There is dedicated space for staff to change their clothing. ☐ ☐ ☐

1.12 (*) The units within the care home require daily enhanced cleaning. Refer to VCH/PHC’s LTC Enhanced Cleaning guidance document.

☐ ☐ ☐

1.13 (*)(*)


☐ ☐ ☐

1.13.2 Clear physical distancing indicators are in place throughout clinical and non-clinical areas, i.e. elevators, waiting rooms, staff rooms etc.

☐ ☐ ☐

1.13.2 Stairwell access made available to staff. ☐ ☐ ☐ 1.14 A process in place to provide guidance on elevator capacity. ☐ ☐ ☐ 1.15

Clients/residents are not able to access the nursing station or staff lounge. ☐ ☐ ☐

2) Education

2.1 (*) All care staff have received education on appropriate use of personal protective equipment, based on guidelines. ☐ ☐ ☐

2.2 (*) All care staff training and education has been documented. Please refer to the LearningHub Modules for online education resources.

☐ ☐ ☐

2.3 (*)(*) All care staff are aware of appropriate donning and doffing procedures. ☐ ☐ ☐


☐ ☐ ☐



3.2 PPE carts are readily available and accessible for clients/residents on isolation. ☐ ☐ ☐


☐ ☐ ☐

3.4 Single use, disposable equipment and supplies used if possible. Dedicate equipment, if possible. ☐ ☐ ☐

3.5 (*) Products (e.g. creams, lotions) are dedicated to a single client/resident, if possible. ☐ ☐ ☐

3.6 Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment. ☐ ☐ ☐

4) Environment 4.1 (*)(*) High touch points (e.g. side tables, side rails, chairs, hand ☐ ☐ ☐










4

washing sinks, medication carts, charting desks, touch screens, white boards, outside of sharps containers etc.) in common areas are cleaned and disinfected at least 2x per day (refer to the Cleaning and Disinfecting Guidelines).



☐ ☐ ☐

4.5 (*)

Any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected using the routine department practices for cleaning and disinfecting between clients/residents.

☐ ☐ ☐

4.8 Containers that are used for decanting are cleaned, disinfected and dried in-between use. ☐ ☐ ☐



Compliance Score

Total number of “Yes” Compliance Score: ________________ % 𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 (𝐶𝐶𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 𝑠𝑠𝑐𝑐𝑐𝑐𝑠𝑠𝑐𝑐) =



Total number of items (Yes + No’s, exclude N/A)




Community-Based Clinics Infection Prevention and Control COVID-19 Recovery Checklist


Instructions

1. Assemble an assessment team that includes site leadership and representation from the Joint Occupational Health and Safety Committee (JOHSC). For sites without a JOHSC, the applicable worker representative should be part of the assessment team.

2. Review the Community-Based Clinics Key Principles and Safety Plan to ensure that your site has implemented all the Employee Safety , Infection Control and Public Health recommendations. Please add any additional information that would be essential for your team.

3. Perform visual inspection of the site.





o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the site is prepared from an Employee Safety, Infection Control and Public Health standpoint. Ultimately, this decision must made by the assessment team.

7. Review outstanding issues/concerns and prepare the site for service recovery.



Facility/Site:

Date :


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Recovery%20Infection%20Control%20Key%20Principles%20and%20Considerations%20_%20Community%20based%20Clinics.pdf


Community-Based Clinics- Infection Prevention and Control COVID-19 Recovery Checklist

2

Element Compliance




1.2 (*)(*)

1.2.1 Environmental Services (EVS) contract in place, identifying: ☐ ☐ ☐ 1.2.2 Routine cleaning and disinfection procedures. ☐ ☐ ☐ 1.2.3 Frequency of cleaning. ☐ ☐ ☐


1.2.5

Terminal cleaning of rooms suspected of contamination from symptomatic patients ☐ ☐ ☐

1.2.6 Management is aware of policies and procedures of contracted EVS staff. ☐ ☐ ☐

1.3 (*)





1.4 (*)(*)

1.4.1 There is a process in place for clinician’s virtual visit or telephone consultation. ☐ ☐ ☐

1.4.2

There is a process in place for staff to pre-screen patients requiring an appointment to the clinic. Please refer to the Screening SOP and the following script for guidance. Patients will also be screened upon arrival at the entrance of the facility and/or at clinic reception. Please refer to the Screening SOP, the high-level screening script and the full screening script for guidance.

☐ ☐ ☐

1.4.3

Points of entry have controlled access in place to facilitate: 1. Screening for symptoms 2. Performing hand hygiene 3. Providing surgical/procedure masks if required 4. Patient flow (with physical distancing)

☐ ☐ ☐

1.4.4 Reception and other staff where feasible can maintain a 2 meter distance from clients/patients, have a physical barrier or wear PPE.

☐ ☐ ☐

1.5 There is a process in place to screen patients for COVID-19-like symptoms upon arrival at the clinic. ☐ ☐ ☐

1.6 (*)(*) Dedicated examination room and/or waiting room is available for direct placement of symptomatic/high-risk patients.

☐ ☐ ☐

1.7 (*)(*) There is a process in place to take patients presenting with COVID-like symptoms to the dedicated examination room and/or waiting room.

☐ ☐ ☐

1.8 (*)

There is a process in place that the examination room for symptomatic/high risk patients should be closed until terminal clean can be performed; if not possible, the examination room/waiting room should be terminally cleaned at the end of the day. Refer to VCH’s Cleaning and Disinfecting Guidelines.

☐ ☐ ☐


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_Appointment%20Reminders_Community.pdf







3


1.10 (*)(*)


☐ ☐ ☐

1.10.2 Personal protective equipment (PPE) is available for staff as outlined in the PPE Recommendations for Community Care Settings.

☐ ☐ ☐

1.11 (*) Alcohol-based hand rub (ABHR) is available at entrance and exit from clinical and non-clinical areas. ☐ ☐ ☐

1.12 (*)(*)

1.12.1

Visual alerts (e.g., signs, posters) indicating PPE donning and doffing steps, hand hygiene, respiratory etiquette and physical distancing are present throughout clinical and non-clinical areas.

☐ ☐ ☐

1.12.2 Clear physical distancing indicators are in place throughout clinical and non-clinical areas, i.e. elevators, waiting rooms, staffrooms etc.

☐ ☐ ☐


1.13 If applicable, there is a process in place to provide guidance/update to elevator monitors with elevator capacity.

☐ ☐ ☐


1.15 (*)

Non-clinical areas (e.g., waiting area) have been de-cluttered removing non-essential items (remote control, magazines, toys, etc.) Refer to De-clutter Audit Tool.

☐ ☐ ☐


2) Education



☐ ☐ ☐

2.3 (*) Medical and non-medical staff training and education has been documented. (e.g. sign in sheets, training log)

☐ ☐ ☐



☐ ☐ ☐


3.1 (*)(*) PPE supplies are readily available and accessible in appropriate sizes ☐ ☐ ☐

3.2 ABHR are located at point of care (clinical areas). Soap, water, and paper towel is available for use at hand washing stations

☐ ☐ ☐


3.4 (*) Staff/Medical staff should avoid unnecessary travel between rooms/areas for assessment and/or treatment and review workflows for reducing travel between

☐ ☐ ☐









4

rooms/spaces within clinics. Specifically the number of treatment bays used by an individual staff should be limited/designated per clinic.

4) Environment

4.1 (*)(*)

High touch points (e.g. side tables, side rails, chairs) in patient care area and anything in the room that was in contact with the client are cleaned and disinfected between patients/clients.

☐ ☐ ☐



☐ ☐ ☐



☐ ☐ ☐


4.7 (*)

Any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected using the routine department practices for cleaning and disinfecting between patients.

☐ ☐ ☐




Compliance Score





“N/A”)


5



1

Community-based Home Visits and Outreach Infection Prevention and Control COVID-19 Recovery Checklist


Instructions

1. Assemble an assessment team that includes department leadership and representation from the Joint Occupational Health and Safety Committee (JOHSC). For sites without a JOHSC, the applicable worker representative should be part of the assessment team.

2. Review the Community-Based Home Visits Key Principles and Safety Plan to ensure that your department has implemented all the Employee Safety, Infection Control and Public Health recommendations. Please add any additional information that would be essential for your team.

3. Perform visual inspection of the space.





o Note: The compliance score is used to inform discussion. A compliance level of >80%, that meets all mandatory elements, signals that the department is prepared from an Employee Safety, Infection Control and Public Health standpoint. Ultimately, this decision must made by the assessment team.

7. Review outstanding issues/concerns and prepare the department for service recovery.



Department:

Date:


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Recovery%20Infection%20Control%20Key%20Principles%20and%20Considerations%20_%20Community%20based%20Home%20Visits%20and%20Outreach.pdf


Community-Based Home Visits & Outreach: Infection Prevention and Control COVID-19 Recovery Checklist

Element Compliance



1.1 (*) The team’s capacity to accommodate appropriate patient flow is assessed on a regular basis. ☐ ☐ ☐

1.2 (*)(*)

1.2.2 Staff are aware of routine cleaning and disinfection procedures to be used in home and outreach environments.

☐ ☐ ☐

1.2.3 Staff have access to VCH approved cleaning and disinfection wipes that can be easily carried to home environments.

☐ ☐ ☐

1.2.4 Re-usable equipment is cleaned and disinfected after use with each client. ☐ ☐ ☐

1.2.5 Management is aware of policies and procedures required to clean and disinfect items used in the home environment.

☐ ☐ ☐

1.2.6 Site specific workflows are established for staff to follow with regard to cleaning and disinfection of equipment and surfaces in the home environment.

☐ ☐ ☐

1.3


1.3.2 (*)(*) Not coming to work sick. ☐ ☐ ☐ 1.3.3 Staggered start times. ☐ ☐ ☐ 1.3.4 Staggered break times. ☐ ☐ ☐ 1.3.5


1.4 (*)(*)

1.4.1 There is a process in place for staff to conduct virtual visits or telephone consultations. ☐ ☐ ☐

1.4.2 There is a process in place for staff to screen patients prior to home visits. Please refer to the Screening SOP and the following script for guidance.

☐ ☐ ☐

1.4.3 There is a process in place for staff to screen patients at the start of the home visit. Please refer to the Screening SOP for guidance.

☐ ☐ ☐

1.5 (*) There is a process in place for booking high-risk patients at the end of the day, if possible (e.g. non-COVID, symptomatic for COVID but undiagnosed, COVID-19+).

☐ ☐ ☐

1.6 (*)(*) Personal protective equipment (PPE) is available for staff as outlined in the PPE Recommendations for Community Care Settings.

☐ ☐ ☐

1.7 (*)(*) Alcohol-based hand rub (ABHR) is available in portable sizes that can be easily carried by staff to home or outreach visits

☐ ☐ ☐

1.8 Staff bring minimal equipment with them to the home or outreach visit. ☐ ☐ ☐

1.9 (*)(*) Supply bags are made of materials that are easily cleaned and disinfected. ☐ ☐ ☐

2) Education



☐ ☐ ☐


http://ipac.vch.ca/Documents/COVID-19/Recovery%20Resources/Community/Script_%20Appointment%20Reminders_Home%20visits%20Outreach.pdf







2.3 (*) Medical and non-medical staff training and education has been documented (e.g. educational logs or sign in sheets). ☐ ☐ ☐


2.5 (*) Medical and non-medical staff have been provided information relating to COVID-19 and the measures in place to ensure safety

☐ ☐ ☐

3) Routine Practices



3.3 (*)

During the pre-visit screening and start of the home or outreach visit, staff should remind and ask family/visitor/support present in home, to maintain two meters distance from patient and staff during care. Note: Family that is a primary care giver may need to be involved with client care.

☐ ☐ ☐

4) Environment

4.1 Staff provide client and family education on cleaning and disinfection of common surfaces throughout the home. ☐ ☐ ☐

4.2 Products (e.g. creams, lotions) are dedicated to the client. ☐ ☐ ☐

4.3 (*)

Any medical/clinic equipment used (e.g. blood pressure cuffs, clipboard) should be cleaned and disinfected using the routine practices for cleaning and disinfecting between patients.

☐ ☐ ☐

Compliance Score





“N/A”)

