Switching clinical care between a bench and the screen

David Bradley Sports Medicine & Rehabilitation Centre transition to provide a hybrid model of patient care under the current government restrictions

_{Graphic by Esra Rakab}

We have reached the one-year anniversary of the COVID-19 pandemic in Ontario. In March 2020, the Ontario provincial government issued a state of emergency, ordering several businesses to close down. This included the David Braley Sport Medicine and Rehabilitation Centre, managed by Gloria Kiefer Preston, where she oversaw the functions of the centre while adjusting operations due to the pandemic.

It was not until July 2020 when the clinic was allowed to re-open, while adhering to social distancing guidelines and health and safety measures implemented by authorities. Despite re-opening, there were still restrictions on surgeries, both outpatient and elective.

Preston also noticed a rapid decline in patient registration, leading to decreased operating hours and fewer staff members. Even with fewer patients, appointment slots were still spread out to allow for further sanitation of the clinic spaces.

As instructed, staff and health practitioners have conducted screening required by authorities, alongside wearing adequate personal protective equipment and documenting all visitors.

“Physiotherapists have done a fantastic job at accommodating and have been doing more than [okay],” said Preston. 

Now, as the clinic reduced their operating hours, they have adopted an unconventional method of patient check-ups: telemedicine. As telemedicine is not as prominent in sports, due to the frequency of hands-on assessments, closures due to the pandemic have enabled practitioners with consultations to guide patients to online resources and give medical advice over the phone.

The clinic’s experiential education program — a mandatory component of medical training in a variety of healthcare specialties — had to undergo closures and changes in their operation guidelines, such that the number of student placements had to be reduced. As in-person learning was temporarily put on hold, the transition to online clinical education became a learning curve, adapting to the use of technology for placements for medical residents and physiotherapy students.

Undergraduate kinesiology students were also severely affected, as when the city of Hamilton went into the grey level of lockdown, student therapy placements were not allowed on site until the lockdown level was lifted to red. Student placements predominantly assisted with the screening of athletes.

As part of the clinic’s volunteer program, they transitioned it to online learning but were still able to enroll 75 students. These students had to complete online modules and submit project-based work, such as looking at case studies.

As the government is still aiming to reduce its daily COVID-19 cases and continues with its vaccine rollout program, people are slowly returning to their normal lives with freer schedules as the lockdown has been lifted in their regions.

The clinic’s schedule is now becoming more booked. With that being said, while Preston emphasized there’s still a sense of difficulty in the air, the clinic still aims to continue a hybrid model of patient care and synchronous learning of on-site and online education.

“There was never a “Pandemic 101” course on how to get through a pandemic and it forced us to take a step back and appreciate things,” said Preston.