Precautions for lifting restrictions Private Healthcare Facilities

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AIM

To provide research-based guidance on how best to facilitate the safe and gradual restoration of private healthcare sector services and have effective measures in place to protect the health of patients, and healthcare workers by reducing the risk of COVID-19 transmission during treatment as much as practicable.

COMPLIANCE OFFICER

Appoint a designated employee to act as a Compliance Manager to ensure implementation, compliance and monitoring of all guidance including social distancing, hygiene and infection prevention and control.
The designated Compliance Officer must stay abreast, monitor and document compliance with all MOPH issued directives, protocols and guidance.

COVID-19 RISK ASSESSMENT AND RESPONSE PLAN

Develop and update a COVID-19 response plan to deal with suspected/confirmed cases of COVID-19 in the workplace and specify what is to be done if an employee displays symptoms during working hours.
Conduct a risk assessment on health and safety before any return to the workplace, and put in place relevant measures to ensure the health and safety of employees in line MOPH guidance. The assessment should cover risks posed by facilities, services, working conditions and the composition of the workforce.
Based on the conducted risk assessment, develop a plan for resumption of services and staff return to work in line with the phases.
A log of all participants in any group activity or service that require multiple staff (such as surgical procedures, group therapy sessions, etc.) is kept to facilitate contact tracing if needed.
Consider completing a return to work form for all staff before resuming duties.

PHYSICAL DISTANCING

The occupancy rate of health facilities should not exceed 40% of the total capacity.
Maintain a 1.5 meters minimum distance between people (staff and patients).
Protective screens must be used to separate staff and patients unless it will impact delivery of services.
Reduce numbers of employees working onsite as per guidance in each phase
Continue to provide tele-medicine services as possible.
Use floor and furniture markings to maintain appropriate social distancing for patients and staff.
Remind staff of distancing requirements - Clear and visible signage

INFECTION PREVENTION AND CONTROL

All employees must undergo regular testing as per MOPH guidance (at employer cost).
Ehteraz App to be downloaded by all employees and customers, and check that the status is green to allow entry.
Measure temperature of employees and patients on arrival. Set up separate pathway for patients with temperature more than 38 degrees as per COVID-19 protocols.
Hand sanitizer to be provided for employees and patients use at several locations within the facilities.
Masks to be worn by employees and patients at all times.
PPE to be provided to all health workers – full PPE for those making interventions that cause splashes, such as dental treatment or others.
Disposable gloves are mandatory for all staff as per MOPH protocol and need to be replaced after every patient encounter.
Avoid handshakes and all forms of physical greetings.
All regularly touched surfaces should be cleaned and disinfected regularly using standard disinfection products.
A cleaning and disinfection schedule of examination rooms, medical treatment rooms, and waiting rooms between each patient should be followed and maintained.
A housekeeping log should be maintained.
Toilets are cleaned and disinfected after each use.

CAPACITY RESTRICTIONS

All facilities must comply with capacity restrictions in each phase.
Consider alternating shifts or alternating clinic days to comply with capacity, 40 minute per patient appointment and social distancing requirements.

APPOINTMENTS AND SCHEDULING

Patients must have pre-booked appointments to be seen. No walk-ins allowed except for emergency and urgent care departments.
Patients cannot be scheduled less than 40 minutes apart (i.e. each patient appoint must be at least 40 minutes) to minimize crowding and ensure sufficient time to clean and disinfect clinics/ rooms.
Priority given to patients with complex or multiple chronic conditions.

WAITING AREAS

Patients attend health facilities only 5 minutes before the scheduled time.
Clinic waiting for areas to allow minimum space of 9 meters square per person.
Do not mix patients with respiratory infection symptoms or high temperature – provide a separate waiting room.
In-facility pharmacy waiting areas must comply with social distancing, floor, and furniture markings. Plastic Shields must be placed between chairs.

ELECTIVE SURGICAL PROCEDURES

Elective patients to undergo COVID-19 screening before procedures.
Avoid elective cases requiring blood transfusions or intensive care in the post-operative period during phase 1 and phase 2.
Full PPE to be worn and replaced after each procedure.

HOME VISITATION

Continue to suspend home health services in various medical specialties (doctors, physical therapy, daily nursing, etc.) except for nursing services provided through long-term contracts.
Home visitation to prioritize patients with critical and complex conditions.
New Full PPE must be worn prior to each visit and properly disposed in specially marked containers following each visit.
All surfaces inside vehicles used to conduct home visits must be adequately cleaned and disinfected daily.

TELEHEALTH CONSULTATIONS

Telehealth consultations and follow-ups, if established, should continue where it is appropriate, depending on the patient’s conditions. Patients at-risk and vulnerable patients (those aged 60 and above, or having complex or multiple chronic conditions) should be prioritized.

MONEY HANDLING

Minimize any cash transactions.
Wipe down credit card readers and other payment methods after each patient/customer use.

PPE SUPPLIES

All healthcare facilities must maintain sufficient PPE supplies including masks, gloves, etc. to cover the needs of both patients and staff.

TOOLS, SUPPLIES AND EQUIPMENT

Single use and disposable tools and supplies must be used whenever possible.
Any reusable tools and supplies must be changed after each use, procedure or patient encounter and properly contained using standard infection prevention and control practices.
All reusable tools and supplies must be properly sterilized using standard infection prevention and control practices.

VULNERABLE GROUPS

Employees over the age of 60 should be advised to work from home and/or delay return to work locations whenever possible.
Employees with chronic conditions should be advised to work from home and/or delay return to work whenever possible.
Require the completion of a return to Work Form for vulnerable or at risk employees.

EDUCATION & AWARENESS

Communicate clearly and early with managers and staff on plans to reopen and any new guidance or policies that will be introduced.
Keep employees updated on COVID safety and prevention information and guidelines.
Emphasis that protecting public health is paramount.
Use MOPH health messages and materials. Let patients know what steps you are taking to keep them safe.

MENTAL HEALTH AWARENESS

Advise employees and patients, who may be experiencing stress or anxiety related to COVID-19 guidance to contact the mental health hotline 16000. Refer patients according to MOPH Policy for ‘Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak’.

COVID-19 Services Assistant خدمة المساعدة الخاصة بكوفيد-19