Our Protocal for Office Operations during the Corona Virus Pandemic:
We wanted to thank all of you for your patience and perseverance during this trying time. Our clients are absolutely the most important part of our office and we appreciate you more than you know. We have a wonderful team that has dedicated many hours during this pandemic to discuss the best approaches and we will continue our safe and effective operations as a Washington Department of Health accredited and Accreditation Association for Ambulatory Health Care accredited ambulatory surgery center and medical clinic.
To create the safest environment, we will be implementing and attempt to exceed the current social distancing measures, engineering / administrative controls, safe work practices and up to date usage of Personal Protective Equipment based on the most current CDC, OSHA guidelines and other important relevant sources (See all of our links to these sources of information below). For the well being of our staff and all of our clients, the safety measures below will be followed with no exceptions.
- Prior to your appointment or procedure, you will undergo a corona virus screening and will only be allowed to come into the office if you answered no to the following questions. If you answer yes to any of these questions, you will be rescheduled after resolution of your situation.
-Have you had any symptoms of fever, body ache, dry cough, sneezing, fatigue, chills, headache, sore throat, loss of appetite, loss of smell / taste, rash, discoloration of your fingers or toes, runny nose, diarrhea, nausea, and vomiting for the past 14 days?
-Have you travelled by plane out of state or internationally in the past 14 days?
-Have you been exposed to someone with these symptoms in the past 14 days.
- Before entering our office, we will have you wait in your car until a room becomes available. Once inside the office, we will ask you to sterilize your hands with the hand sanitizer in the front lobby. Patients will then be further screened with an infrared, no-contact thermometer and then escorted into their own individual room.
- If you have a temperature greater than 99.1 F (37.3 C) we will need to reschedule you based on these same safety measures. In addition, you may consider monitoring for symptoms and also testing for SARS-CoV-2.
- Only patients receiving treatment will be allowed inside the office.
- Once inside your treatment room you can further disinfect by washing your hands.
- There will be nobody allowed to wait in our waiting room.
- Patients can wear their own masks, unless they are deemed unfit to ensure adequate protection. If deemed necessary, patients will be required to wear one of our medical grade masks. Patients will be required to wear the mask during their treatment while maintaining the appropriate sterility.
- Payments, reward programs, future scheduling and & checkout will be performed in your treatment room.
- Self-service hospitality stations will be discontinued to decrease spread of the virus.
- Patients will be asked to use their bathroom in their own homes or businesses prior to coming to our office.
- All patients will need to have all of their initial patient medical history intake forms filled out prior to coming to the office to avoid spreading the virus through paperwork.
- Patients entering and leaving the facility will be coordinated in a staggered fashion so that you will not encounter other clients as much as possible.
- Our staff will also limit the number of times we enter and exit your treatment room to limit your exposure.
- We will perform virtual follow-ups and consultations and have in person meetings only for pre procedure appointments and the particular procedure as necessary.
- For all Surgical Procedures (Local and IV sedation), we will be testing our patients for SARS-CoV-2 before their procedures as close as possible to the date of their procedure, pending testing capabilities. We will also have all of our surgical and filler patient’s self-quarantine for 14 days prior to their procedures. We will be sending most of our patients to a separate corona virus test site. If you are positive, your procedure will be postponed and we will reschedule you and you will need to go through this protocol again.
- After your surgical procedure, we will encourage you to self-quarantine for at least 14 days.
- Precautions in the pre and post surgery periods are based on reports of increased morbidity and mortality for patients who have surgery during the incubation period of COVID-19.
- Prior to any treatment, surgical or non-surgical, we will be having all patients read, understand and sign an informed consent pertaining to receiving an elective treatment during the Corona Virus pandemic.
- Based on current information, patients are in the higher risk category if they are: age > 65, patients with Diabetes, Hypertension, Cardiac Issues, COPD / Chronic Obstructive Pulmonary Disease, Asthma, Obesity BMI > 30-40, kindey disease, liver disease, Immunosuppression, Hemoglobin disorders. Other risk factors to consider include: race / ethnicity, gender (fatality rates 1.7% Females, 2.8% Males), number of major disease processes (1 - 79% greater chance of requiring ICU / respirator / dying, 2 or more diseases 2.5 times the chance). If you are in this category, we will discuss based on a case-by-case basis your particular situation and the possibility of you having a procedure.
- We will limit paperwork and exchange of other physical items as much as possible and encourage communications through the Internet, email (contactus(at)afbplasticsurgery.com, fax (425-990-3225) and secure messaging.
- We will be limiting non-essential staff, observers, students and industry representatives.
- Any products purchased from our office will be sterilized with Environmental Protection Agency (EPA) approved disinfectant before giving to a patient.
- When possible we will encourage mailing our products instead of having patients come in for purchases.
- Employees will be required to stay home: 1. If they have the same symptoms and time stipulations as we are requiring for our patients; 2. If they are not infected but have a family member at home infected with SARS-CoV-2; 3. If they have a temperature greater than 99.1 F (37.3 C).
- All employees will have the same screening as our patients at the start of each working day.
- If any employee develops any of the symptoms mentioned or is exposed to someone with any of the symptoms above, they will be asked to get tested for SARS-CoV-2 and will begin a quarantine period that will continue until at least 14 days after the last symptoms.
- All of our staff will be required to wear masks while working and other PPE’s when appropriate (i.e. eye protection and gloves while cleaning the rooms).
- All staff that will come in within 6 feet of our patients will be required to wear all recommended Personal Protective Equipment (PPE) including surgical masks and / or eye protection, face shields, and gloves during treatments.
- During surgical procedures and for botox and fillers, our staff will be wearing Powered Air Purifying Respirators (PAPR). Normal surgical masks are less efficient than n95 masks that have approximately an Assigned Protection Factor (AFP) of 10 or less. Some studies suggest that n95 masks have an APF of 5. These PAPR’s can have an APR of up to 1000. This will reduce your exposure to the virus exponentially.
- We are planning on wearing PAPR's during other office procedures including botox, steroid injections and possibly extensive follow-up appointments.
- We will be utilizing High Efficiency Particulate Arrestance / Air Filters in the main lobby and in the surgery room that studies show may help remove as much of the circulating microbes as possible.
- We have 3 more efficient Jade HEPA air filters in our main lobby waiting room, the main procedure preparation room and the operating room. These Jade HEPA air filters will incorporate the following 6 different technologies that help remove microbes like the coronavirus: 1.) Ultra-fine particulate filters - that remove microbes up to a size as small as 0.1 microns. The coronavirus is between 0.06 and 0.14 microns. Pre filter and HEPA RX with a MERV rating of 17; 2.) Dual-Stage carbon & molecular sieve - absorbs chemicals, gases and odors; 3.) Germicidal UV-C plus chamber - Denatures DNA; viruses, bacteria, allergens, mold, mildew; 4.) Super Oxidizing Photo-catalytic Nano-TiO2 - which increases DNA kill; 5.) Hydroxyl Radical Reactivity Chamber- destroys VOC, mold, mildew and bacteria; 6.) Revitalizing Negative Ion Chamber - neg ion's attach to ultra-fine particles and drops them out of your breathing space. Increase mental clarity, and serotonin.
- We will have clear plastic sneeze guards in the front to protect you and our staff during the initial front desk interactions.
- Tissue, no hands trash receptacles, and alcohol-based hand sanitizers with at least 60% alcohol will be placed in each room including an Environmental Protection Agency (EPA)-approved disinfectant and liquid soap where appropriate for your sanitizing needs.
- All employees will be required to use their own workstation computers and other office equipment with no cross contamination.
- Cleaning and disinfection of all frequently touched surfaces and treatments rooms will be followed after each patient visit or patient contact with an Environmental Protection Agency (EPA)-approved disinfectant (Cavi-wipes).
- All staff will maintain at least 6 feet distance from each other as much as possible. We realize that this is not possible in certain situations (i.e. surgery).
- All staff will continue, as before, their regular, normal hand washing protocol per CDC, respiratory etiquette, and other safety practices per CDC and Washington Department of Health guidelines. They are encouraged to self-monitor for COVID-19 symptoms and stay at home if they are sick. They will be protected with more flexible policies related to being sick, which in turn will ensure more of your safety per OSHA guidelines.
- Our staff will be encouraged to discontinue non-essential travel to places with SARS-CoV-2 outbreaks.
- Regular weekly meetings will be conducted to continue training and education on the most up to date information on Corona Virus safety and overall safety for an ambulatory surgery center.
- This protocol will also likely be updated if necessary, based on the latest updates as we receive them.
We feel very fortunate to be working during the pandemic. The most important part of all this is you, our wonderful patients. We know, and we talk about this all the time, that our clients are the most important part of our office by far. We have the safest environment for you and we are ready to continually help you with your results and achieving the best you! Thank you for your patience during this unprecedented time of our lives. The measures above are being implemented for the safety of our staff, our clients, our community and our world. If we all contribute to each and everyone’s well being with love and understanding, we will get through this pandemic with the least amount of cases, deaths and damage to our great nation and world.
Sincerely,
Dr. Philip Young and the Staff at Aesthetic Facial Body Plastic Surgery
Important Links:
https://www.nejm.org/doi/full/10.1056/NEJMoa2034577
https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/WA-COVID-19-Vaccination-Plan.pdf
https://www.doh.wa.gov/Emergencies/COVID19/vaccine
https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/PPEPrioritization
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
https://www.osha.gov/Publications/OSHA3990.pdf
https://www.governor.wa.gov/news-media/chart-washingtons-phased-approach
https://www.osha.gov/Publications/OSHA3990.pdf
https://www.osha.gov/Publications/OSHA3990.pdf
https://www.osha.gov/Publications/OSHA3990.pdf
https://www.governor.wa.gov/news-media/chart-washingtons-phased-approach
https://www.governor.wa.gov/sites/default/files/proclamations/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf
https://www.seattleface.com/blog/blog/announcement/new-health-and-safety-precautions
https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf
https://www.governor.wa.gov/sites/default/files/Non-Emergent%20Procedure%20Interpretive%20Statement%204.29.20%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery
https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/PPE-Reuse.pdf
https://www.osha.gov/SLTC/etools/respiratory/index.html
https://www.osha.gov/Publications/3352-APF-respirators.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589166/
https://www.reliasmedia.com/articles/24180-n95-mask-may-provide-less-protection-than-believed
https://www.plasticsurgery.org/for-medical-professionals/covid19-member-resources/resumption-of-elective-surgery
https://www.consumerreports.org/air-purifiers/what-to-know-about-air-purifiers-and-coronavirus/
https://www.nbcnews.com/shopping/home/best-air-purifiers-2020-according-doctors-experts-n1183336