COVID-19 guidance and direction for R.Kins

Since the start of the pandemic, the College has provided various advice and direction to kinesiologists. Here are links to recent emails:

Currently, the Chief Medical Officer of Health's (CMOH) directive is in effect for all kinesiologists. If this directive changes, we will update all kinesiologists accordingly.

To re-cap: On March 19, 2020, the CMOH issued a directive to all regulated health professionals or individuals who operate a group practice of regulated health professionals (e.g. clinic owners). The CMOH directed that all non-essential and elective services should be ceased or reduced to minimal levels, subject to allowable exceptions, until further notice. Allowable exceptions can be made for time sensitive circumstances to avert or avoid negative patient outcomes, or to avert or avoid a situation that would have a direct impact on the safety of patients. Read the directive.

What the CMOH's directive means for kinesiologists

All kinesiologists must follow the CMOH's directive and ensure that they are only providing essential services. We have developed several FAQs on this directive and what it means for kinesiology practice. Jump to the FAQs.


Guidance for kinesiologists


FAQs

What does the College consider to be essential vs. non-essential service?

Service can only be considered essential in cases where the patient’s/client’s health or function would considerably decline if service was not provided. All other services, while an important part of one’s overall health, would be considered non-essential during this time.  

You will need to use your professional knowledge and judgement to honestly determine whether a service is essential before providing it. The Chief Medical Officer of Health has directed that the only allowable exceptions are for time sensitive circumstances to avert or avoid negative patient/client outcomes, or situations that would have a direct impact on patient/client safety.

We expect further guidance from Ontario Government on essential vs. non-essential service, and there is no one-size-fits-all approach to questions of what is/is not essential. Listed below are some questions to consider when making clinical judgements and ethical decisions about continuing service with patients/clients:

• Have I prioritized patients/clients according to their individual risk?
• What are the possible consequences to the patient/client if I do not provide the service?
• If a patient/client does not receive service at this time, will they deteriorate and be at risk for hospitalization or further use of the healthcare system?
• Can I meet some of the patient’s/client’s needs using alternative means for service, such as virtual or phone check-in, as a way of bridging service?
• Can I work with my other health system partners and referral sources to identify clients with urgent needs?
• Does my organization have pandemic tools and resources to help me make decisions about service priorities?
• What is the impact on my patient/client if I were asked to work elsewhere in the healthcare system to respond this pandemic?
 
If you determine it is necessary to provide service, please ensure you are following the College’s Practice Standard- Infection Control and the Ontario Ministry of Health's guidance for health professionals.

If I provide service after this recommendation was announced, is this considered professional misconduct?

No. The College issued a recommendation and encouraged kinesiologists to use their judgement to determine whether or not service is necessary. We understand that some kinesiology services will continue during this time. Our goal is to encourage and support recommendations from all levels of government to avoid non-essential contact.

At this point, my place of employment is still open. What should I do given the College’s recommendation?

You and your employer will need to assess the risks of providing or not providing service. We understand that you may be concerned with the implications of refusing to provide service (e.g. getting laid off). The College cannot comment on these matters.

Ontario's Chief Medical Officer of Health also recommends considering the following principles when making decisions about whether to provide service during this time:

1. Proportionality. Decision to eliminate non-essential services should be proportionate to the real or anticipated limitations in capacity to provide those services.
2. Minimizing Harm to Patients. Decisions should attempt to limit harm to patients wherever possible. This requires considering the differential benefits and burdens to patients and patient populations as well as available alternatives to relieve pain and suffering.
3. Equity. Equity requires that all persons in the same category (i.e. at different levels of urgency) be treated in the same way unless relevant differences exist. This requires considering time on wait lists and experience with prior cancellations.
4. Reciprocity. Certain patients and patient populations will be particularly burdened as a result of cancelling non-essential services. Patients should have the ability to have their health monitored, receive appropriate care, and be re-evaluated for emergent activities should it be required.

If after a careful risk assessment you and your employer determine it is necessary to provide service, please ensure you are following the College’s Practice Standard- Infection Control and the Ontario Ministry of Health’s guidance for health professionals.

Can I provide services virtually at this time?

The College has compiled more information on this topic in a comprehensive virtual care FAQ.