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  • APTA Provides COVID-19 Outpatient Practice Resources

    Information around physical therapy and COVID-19 continues to evolve. Here's a recap of resources APTA has developed to help outpatient practices.

    While APTA points PTs, PTAs, and physical therapy students to the latest CDC guidance related to the COVID-19 pandemic, the association continues to track and respond to the needs of providers in various circumstances, including in outpatient settings. Here are recommended resources to date.

    APTA Guidance

    FAQ: Physical Therapist Management of Patients With Diagnosed or Suspected COVID-19
    "How do I decide whether or not — and how — to treat patients during the coronavirus pandemic? How can I keep my patients and employees safe? What information should I consider when determining whether in-person physical therapist services are appropriate for my patients?" These questions are top of mind for outpatient PTs and PTAs. The guidance in this FAQ includes information for outpatient clinics, keeping in mind that each practice, patient, and community are unique.

    Based on federal guidelines, the resource addresses some of the most common concerns of PTs and PTAs in outpatient settings, including:

    • When should I tell patients not to come in for their outpatient PT visit because of heightened risk for COVID-19 infection?
    • How do I make decisions about providing services in my outpatient facility?
    • How can I prepare my physical space and operations to reduce risk of infection?
    • Do I need to use personal protective equipment when treating patients?
    • Are there ways to encourage patients to stay active while they're at home?
    • What do I do about patients who are high risk and should not come to in-person visits?

    The FAQ also includes a summary of CMS guidance for outpatient services, including staff monitoring and return-to-work decisions, facility closings, health and safety requirements, and PPE considerations.

    APTA Telehealth Resources, Courses, and Webinars
    COVID-19 is changing the landscape of telehealth and other communication technology-based services. Explore this page for guidance on use of remote communication technologies for physical therapist services; updates on state and federal payment; advocacy opportunities; and free and members-only courses and webinars to help bring you up to speed.

    Official APTA Statements

    Letter From APTA President Sharon Dunn on the Impact of COVID-19
    In a March 20 letter to members, APTA President Sharon Dunn, PT, PhD, wrote about this "challenging time to be in health care," commending the "heroic" actions of PTs who continue care for those who urgently need it and those who close their doors to decrease the risk of spreading infection.

    APTA Statement on Patient Care and Practice Management During the COVID-19 Outbreak
    On March 17, APTA's Board of Directors released a statement encouraging PTs, PTAs, and students to "flatten the curve of the COVID-19 outbreak by following CDC guidance to minimize exposure in the clinic and practice social distancing by avoiding large social gatherings. At the same time, we know that our profession plays a crucial role in the health of our society, and there are people in our communities whose health will be significantly impacted by disruptions to care.

    "Patient care has always been specific to the individual, with the physical therapist assessing a person's needs relative to their goals. Thus, physical therapists have a responsibility to review CDC guidance, to understand who is at highest risk and how to best reduce exposure, and to use their professional judgment in the best interests of their patients and clients and their local communities — including rescheduling nonurgent care if that is the best approach, or making other adjustments when the risk of exposure to COVID-19 outweighs the benefits of immediate treatment."

    APTA's Position Statement on Communicable and/or Infectious Diseases and Conditions: Rights of Patients and Providers in Physical Therapy
    In 2019, APTA's House of Delegates passed HOD P06‐19‐74‐40, which addresses physical therapy providers' responsibilities and ethical obligations when providing care to individuals with communicable disease, or when they themselves have or are at risk for infection. According to the statement, "Physical therapy providers shall deliver quality, nonjudgmental services in accordance with their knowledge and expertise to all persons who need it, regardless of the nature of the health problem. When providing services to individuals with infectious disease, physical therapy providers shall follow guidance provided by authoritative bodies such as the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA)." This guidance is applicable to all practice settings.

    Insight From APTA Colleagues

    Facebook Live Recording: Adapting Your Outpatient Practice During the COVID-19 Crisis
    Recorded from an APTA Facebook Live Event, physical therapists Patrick Cayen PT, MBA, Josh D'Angelo, PT, DPT, and Kimberly Richards, PT, DPT, describe the changes they have made to their outpatient practices and answer questions from viewers.

    PT in Motion: "Defining Moment: Vulnerability and Courage"
    In an advance-access column from the upcoming May issue of PT in Motion, read a personal account of a Washington state outpatient physical therapist who made the hard decision to keep her clinic open during the COVID-19 pandemic.

    #PTTransforms Blog: "Flexibility in the Face of COVID-19: Lessons From a Rural Washington Critical-Access Hospital"
    In this blog post, another Washington physical therapist describes a different experience, as her facility-based outpatient clinic closed to protect patients – and its staff retrained to assist in other areas of the hospital.

    #PTTransforms Blog: "The Heart of the Storm: I'm a PT in Manhattan. Here's What it's Been Like"
    A New York City physical therapist explains how her employer reacted to the COVID-19 crisis, as patient care became more dangerous and caseloads dwindled, urging readers to "think outside the box."

    An APTA HUB Thread for Members to Share Outpatient Experiences
    APTA has created a thread on the Council on Health Prevention and Wellness forum and the Council of Health Systems Physical Therapy for members to share insights and experiences. The thread includes a post from Advocate Aurora Health on how they approach patient care for outpatient rehabilitation. Please keep in mind that individual clinics will vary in how they respond to COVID-19 based on their patient populations and available resources. If you have another great example of how you are making clinical decisions about your outpatient practice, email practice-dept@apta.org so we can share your story, or go to this dedicated online community to participate in the discussion with other HUB community members.

    Comments

    • So far I haven't seen any comments about home care patients. What are your thoughts?

      Posted by Barbara Melinek on 4/22/2020 6:03 PM

    • @Barbara: please check out http://www.apta.org/PatientCare/COVID-19/PatientManagementAdult/ and http://www.apta.org/PTinMotion/News/2020/03/31/WhereThingsStandPracticeGuidance/ For additional guidance, please refer to the resources found on APTA’s coronavirus page: http://www.apta.org/coronavirus/

      Posted by APTA staff on 4/23/2020 9:17 AM

    • I have looked at the CDC guidelines and APTAs statements on PT OP clinic procedures and what I see relates to what to do when you have patients that have symptoms or are recovering from Covid-19. The evidence has shown that recovered patients can be shedding virus 30+ days after onset of infection even though they now are not symptomatic. Evidence has also shown that asymptomatic patients can be carriers spreading disease. So exactly what are CDC and APTA guidance for protecting clinic staff and social distancing in the clinic? What PPE should be provided to staff? Should all patients be wearing masks. PTs can't practice social distancing since treatment is in close proximity and touching patients. Where is APTA guidance on this? Everything that I have seen from APTA is nebulous and confusing.

      Posted by Fred Nesvet on 4/27/2020 3:51 PM

    • Any guidelines on returning to patient care in outpatient and prioritizing patients? Thanks

      Posted by Jennifer Trizuto on 5/5/2020 1:51 PM

    • Do we, as an organization, have collective buying power to access PPE? Such as KN95 masks, gloves, disinfectant products?

      Posted by Leslee Olender on 5/13/2020 11:20 AM

    • Do we, as an organization, have the collective buying power to access PPE? Such as KN95 masks, gloves, disinfectant products? Ex. we are not listed as a Covid-19 accepted business organization to make purchases on Amazon. How can we get listed, like Chiropractors which are currently listed? I know we have other sources of to purchase, but can Amazon be one of them? I wouldn't want to take PPE away from Hospitals or Nursing homes.

      Posted by Carol Murfin on 5/14/2020 7:25 AM

    • As a patient should I expect that staff at my PT provider will be wearing masks and that they will require other patients to wear masks? The office I have always gone to has made masks optional. This seems to me to NOT be a best practices decision.

      Posted by Patric on 5/15/2020 5:54 PM

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