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Gynecology Centralized Access - Facilitated Access to Specialized Treatment (FAST)   at
South Zone and Area
Central Access Healthcare Service
Specialty: Gynecology
Estimated time to routine appointment: Not Available
Alberta Health Services - South Zone
CENTRAL ACCESS SERVICES
Referrals for Gynecology in the South Zone are accepted through this Facilitated Access to Specialized Treatment (FAST) central access and intake program. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider. FAST receives the surgical referrals, reviews them for completeness and duplication, and then sends them to appropriate surgeons for triage and booking.
Referrals for Gynecology in the South Zone are accepted through this Facilitated Access to Specialized Treatment (FAST) central access and intake program. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider. FAST receives the surgical referrals, reviews them for completeness and duplication, and then sends them to appropriate surgeons for triage and booking.
ELIGIBILITY REQUIREMENTS
Review reasons for referral table below for eligibility requirements.
Review reasons for referral table below for eligibility requirements.
Referral instructions for primary care, community care, private
providers etc. who do not send referrals via Connect Care.
REFERRAL PROCESS - FOR NON-CONNECT CARE USERS
1. Complete the referral form or a referral letter stating the reason for referral.
2. Attach all mandatory information to the referral (see Gynecology Adult Referral Pathway)
3. Fax completed referral to South Zone FAST at 1-833-627-7024.
You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.
Urgent Referrals: Call RAAPID South at 1-800-661-1700.
1. Complete the referral form or a referral letter stating the reason for referral.
2. Attach all mandatory information to the referral (see Gynecology Adult Referral Pathway)
3. Fax completed referral to South Zone FAST at 1-833-627-7024.
You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.
Urgent Referrals: Call RAAPID South at 1-800-661-1700.
REFERRAL PROCESS - FOR CONNECT CARE USERS
An Outgoing Referral is required for this service.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in workqueue 5.
Urgent Referrals: Call RAAPID South at 1-800-661-1700.
An Outgoing Referral is required for this service.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in workqueue 5.
Urgent Referrals: Call RAAPID South at 1-800-661-1700.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
ADDITIONAL SERVICE DETAILS
Learn more about FAST at ahs.ca/FAST.
Learn more about FAST at ahs.ca/FAST.
 
CLICK + TO VIEW REFERRAL GUIDELINES
Routine Reason for Referral
Access Targets convey the clinically appropriate timeframe patients should be seen within, by reason for referral and priority level.
Access Target
Required Information/Investigations
Investigation Timing
Additional Details
ASCUS on cervical pap smear
6 Months
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
ASCUS on Pap Smear
(Includes Persistent)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

ASCUS on cervical pap smear with positive HPV DNA test
6 Months
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
ASCUS on Pap Smear with Positive HPV Test
(ASCUS HPV +)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Abnormal uterine bleeding
Pelvic Exam Findings
 
N/A

CBC/Ferritin
 
N/A

Transvaginal Ultrasound Report
 
N/A

Pap Test
 
N/A

STI Screening
 
N/A

Endometrial biopsy (if available) > 40 years old or < 40 year old with significant risk factors present.
 
N/A
Abnormal Uterine Bleeding (AUB)
Includes: Menorrhagia

Adenocarcinoma in situ of cervix
6 Weeks
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
Adenocarcinoma In Situ of Cervix
(AIS)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Amenorrhea
Pelvic Exam Findings or Transvaginal Ultrasound Report if no pelvic exam completed.
 
N/A

Prolactin, TSH, B-HCG, total testosterone with SHBG to calculate free androgen index or Free Testosterone.
 
N/A

FSH/LH/Estradiol: Ideally bloodwork occurs on day 3 of menstrual cycle.
 
N/A

Treatments to date (progesterone challenge)
 
N/A
  • Send referral to Zone FAST Team.
  • Refer to CLINICAL PATHWAY PCOS (Coming Soon)
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide .
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.

Atrophic vaginitis
Description of physical exam findings
 
N/A

Treatments to date
 
N/A
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Atypical glandular cells on cervical Papanicolaou smear
6 Weeks
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
Atypical Glandular Cells on Pap Smear
(AGC)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Atypical squamous cells on cervical Papanicolaou smear cannot exclude high grade squamous intraepithelial lesion
6 Weeks
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
ASC-H On Pap Smear
(ASC-H)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Cancer risk reducing gynecological surgery
Personal or Family history of cancer
 
N/A

Confirmed high risk mutation (ie: BRCA)
 
N/A

Genetics report if available
 
N/A
  • Send referral to Zone FAST Team.

Complication of surgical mesh
Pelvic Exam Findings including a description of findings such as: Description: exposed foreign body or mesh and Patient symptoms (if any)
 
N/A

Surgical history and OR report if available
 
N/A
Mesh Complications (From Previous Prolapse Repair or Incontinence Repair)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Consultation by gynecology service
N/A
 
N/A
Consult for Gynecology Surgery
  • Send referral to Zone FAST Team.
  • Include QuRE Quality referral letter to describe reason for referral

Contraception care
N/A
 
N/A
Contraception
Includes: Birth control, request for tubal ligation.
  • Send referral to Zone FAST Team.
  • Patient self-referral to sexual & reproductive health clinic if available within zone. See Alberta Referral Directory for information of services provided.

Disorder of skin of vulva
Include description of skin abnormality
 
N/A

Biopsy results if available
 
N/A
Vulvar Skin Abnormalities
Includes: Rash, Lichen, Skin Discoloration, Pigmentation changes
  • Send referral to Zone FAST Team.

Dysmenorrhea
Transvaginal Ultrasound Report
 
N/A

CBC, Ferritin if heavy menstrual bleeding.
 
N/A
  • Send referral to Zone FAST Team
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.

Gender affirmation hysterectomy
N/A
 
N/A
Reconstructive Affirming Hysterectomy
  • Send referral to Zone FAST Team.
Additional Resources include:

HSIL on cervical pap smear
6 Weeks
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
HSIL on Pap Smear
(HSIL)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

High risk HPV (human papillomavirus) test positive
6 Weeks
Pathology Report (include both HPV and Pap result).
 
N/A

If available
  • Description of cervix abnormalities
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide
 
N/A
High Risk HPV 
  • HPV 16/18 Positive
  • High Risk HPV Other with HSIL, ASC-H, AGC, AIS
  • Indeterminate or second consecutive invalid HPV test with ASC-H, HSIL, AGC or AIS
  • High Risk HPV Other positive in immunocompromised patients - (HPV Self-Sampling)
  • Persistent High Risk HPV Other
To view more information on HPV Primary, visit: Cervical Screening HPV testing

Lethbridge: Refer direct to Gynecology
Medicine Hat: Send referral to Zone FAST Team

6 weeks for all indications except “Persistent High Risk HPV Other” which is 6 month

Infertile
N/A
 
N/A
Infertility
  • For General Gynecology care refer to Zone FAST Team.
  • For Fertility Specialist care refer as per local zonal processes.

LSIL on cervical pap smear
6 Months
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
LSIL on Pap Smear
(Includes Persistent)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

LSIL on cervical pap smear with positive HPV test
6 Months
Pathology Report
 
N/A

Description of cervix abnormalities
 
N/A
LSIL on Pap Smear with Positive HPV Test
(LSIL HPV +)
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Malignant tumor of pelvis
  • Tumor markers (CA125, CEA)
  • Tumor marker CA 19-9 (Calgary only)
  • CT abdomen, chest, and pelvis
 
N/A
Pelvic Mass (Confirmed Malignancy)
Refer to Gynecologic Oncology as per current zonal practice.

Mass of uterine adnexa
Symptoms
 
N/A

Transvaginal Ultrasound Report
 
N/A
Adnexal Mass
  • Send referral to Zone FAST Team
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.
  • Tumor markers not routinely indicated and may be ordered by specialist as appropriate.
  • Refer to Choosing Wisely

Menopausal vasomotor symptoms
Treatments to date
 
N/A

Recent mammogram, please order if not up to date.
 
N/A
Vasomotor Symptoms
  • Send referral to Zone FAST Team.

Oligomenorrhea
Pelvic Exam Findings or Transvaginal Ultrasound Report if no pelvic exam completed.
 
N/A

Prolactin, TSH, B-HCG, total testosterone with SHBG to calculate free androgen index or Free Testosterone.
 
N/A

FSH/LH/Estradiol: Ideally bloodwork occurs on day 3 of menstrual cycle.
 
N/A

Treatments to date (progesterone challenge)
 
N/A
  • Send referral to Zone FAST Team.
  • Refer to CLINICAL PATHWAY PCOS (Coming Soon)
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide .
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.

Pain in pelvis
Pain history, for example: previous treatments, duration, and results.
 
N/A

Pelvic Exam Findings
 
N/A

Transvaginal Ultrasound Report
 
N/A
Pain in the Pelvis
Chronic (>6months) and not related to menses, if related to menses refer to dysmenorrhea
  • Send referral to Zone FAST Team
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.
Additional Resources while awaiting consult:
  • Consider pelvic floor physiotherapy.
  • Promote to your patients if appropriate:
  1. Power Over Pain Portal
  2. Alberta Virtual Chronic Pain Program

Pelvic mass
  • Tumor markers (CA125, CEA)
  • Pelvic ultrasound or MRI
If tumor markers are normal:
  • Transvaginal ultrasound report
If tumor markers are abnormal: send to Gynecologic Oncology with the following additional information:
  • Tumor marker CA 19-9 (Calgary zone only)
  • CT abdomen and pelvis ordered
  • Pre-menopausal women: Additional tumor markers- AFP, LDH, Beta-HCG
 
N/A
Pelvic Mass
(Suspected Malignancy)
Abnormal Tumor markers and/or ORADS 3 or 4. Refer to Gynecologic Oncology as per current zonal practice. 
South Zone: 
  • Lethbridge: Refer Directly to gynecology.
  • Medicine Hat: Send Referral to Zone FAST Team.

Pelvic organ prolapse
Pelvic Exam findings including a description of findings such as: Size of prolapse, relevant findings and previous treatment initiated.
 
N/A

If prolapse is stage 4 (uterus is grapefruit to basketball size) order creatinine to rule out post-renal obstruction
 
N/A

Polycystic ovary syndrome
N/A
 
N/A
Polycystic Ovary Syndrome
(PCOS)
  • Refer to reason for referral that aligns with patient’s symptoms.
  • Refer to CLINICAL PATHWAY PCOS (Coming Soon)
  • For Amenorrhea, please refer to the reason for referral for process.
  • For Oligomenorrhea, please refer to the reason for referral for process.
  • For Infertility, please refer to the reason for referral for process.

Post gender affirmation surgery problem
N/A
 
N/A
Post Reconstructive Concerns
  • Send referral to Zone FAST Team
Additional Resources include:

Postmenopausal bleeding
Pelvic Exam Findings
 
N/A

Transvaginal Ultrasound Report
 
N/A

Endometrial biopsy is not required. If available, please send results.
 
N/A

CBC/Ferritin
 
N/A

Premature ovarian failure
FSH >40 x2 (minimum one month apart) for initial diagnosis
 
N/A

TSH
 
N/A

Extent of symptoms
 
N/A
Management of Primary Ovarian Insufficiency
(Premature Ovarian Failure)
EXCLUDING INFERTILITY ISSUES
  • Send referral to Zone FAST Team.

Recurrent pregnancy loss, not pregnant
Pregnancies and outcomes
 
N/A
Recurrent Pregnancy Loss
Definition: 2 or more losses and includes non-consecutive and biochemical losses (excludes: ectopic and molar pregnancies)
  • For General Gynecology care refer to Zone FAST Team.
  • For Fertility Specialist care, refer as per local zonal processes.

Suspected benign neoplasm of cervix
Description of cervix abnormalities
 
N/A
Cervical Lesion Suspected Benign
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Transgender related consultation
N/A
 
N/A
Transgender Care
  • Send referral to Zone FAST Team
Additional Resources include:

Urethrovesical fistula
Detailed History: Surgery, Obstetrical History, Pelvic Intervention
 
N/A

Pelvic Exam findings including a description of findings such as: Abnormal appearing vaginal mucosa, Evidence of female genital cutting, Description of findings
 
N/A

No imaging required for referral
 
N/A

Any imaging will be ordered by specialist as necessary
 
N/A
Vesico-Urethral Fistula
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Urinary incontinence
Pelvic Ultrasound with PVR.
 
N/A

Previous treatment initiated (if any)
 
N/A

Within course of illness: Urinalysis and Urine Culture
 
N/A

Pelvic Exam findings including a description of findings such as: Description of vulva, when patient coughs is there leakage? and Description of prolapse.
 
N/A
If unable to complete a trauma informed pelvic exam, indicate reasoning, and provide additional information in a referral letter:
  • Intact hymen
  • Severe vaginismus
  • Post trauma informed discussion, patient still experiencing severe anxiety around pelvic examination.

Uterine adenomyosis
Available Imaging results
 
N/A

CBC/Ferritin if abnormal bleeding
 
N/A

Pelvic Exam Findings
 
N/A
Adenomyosis
  • Send referral to Zone FAST Team
  • If related to Infertility, please refer to the reasons for referral for process.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide

Uterine fibroid
Transvaginal Ultrasound Report
 
N/A

CBC/Ferritin if abnormal bleeding
 
N/A

Pelvic Exam Findings
 
N/A
Uterine Fibroid
Symptomatic and Clinically Concerning
  • Send referral to Zone FAST Team.
  • If related to Infertility, please refer to the reason for referral for processes.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.

Uterine polyp
Transvaginal Ultrasound Report
 
N/A

CBC/Ferritin if abnormal bleeding
 
N/A

Pelvic Exam Findings
 
N/A
  • Send referral to Zone FAST Team.
  • If related to Infertility ,please refer to the reason for referral for process.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide
  • If transvaginal ultrasound not available/appropriate, then trans abdominal pelvic ultrasound is acceptable.

Vaginitis
Vaginal Swab Results
 
N/A

Previous treatment and number of treatments and response
 
N/A
Vaginitis
Includes: Recurrent bacterial vaginosis (BV).
  • Send referral to Zone FAST Team.

Vulval pain
Pain history, for example: previous treatments, duration, and results.
 
N/A

Pelvic Exam Findings
 
N/A

Transvaginal Ultrasound Report
 
N/A
Vulvar Pain Disorders
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide
Additional Resources while awaiting consult:

Vulvovaginal disorder
Description of physical exam findings
 
N/A
Vulvar/Vaginal Abnormalities
Includes: Anatomic abnormalities, Labia hypertrophy (symptomatic), Obstetrical trauma, Agglutination
  • Send referral to Zone FAST Team.
  • If unable to complete pelvic exam, please include reason. Please refer to Trauma Informed Exam Guide


The primary purpose of the All Locations list is to let the user easily access any location of a healthcare service without going back to the main search screen.

The locations listed have 3 background colors:
  • Green means the healthcare service@location has referral information attached to it.
  • Brown means the healthcare service@location never had referral information attached to it, or it has unpublished referral information.
  • Red means
    • IA changed the healthcare service@location's status to something other than Current
    • It was deleted if it is an ARD healthcare service@location.
Green  and Brown are always at the top of the list. These are the Healthcare Service@Locations with the status of Current.
The Red list at the bottom consists of non-current Healthcare Service@locations that once had Published referral information in the ARD.
If the referral information was never published in ARD the Healthcare Service@location will not show in the Red list.

The secondary purpose of the All Locations list is to allow ARD Administrators to recover (copy) referral information from the non-current Healthcare Service@Locations to ones that are current.

Common Scenario:
A Healthcare Service moves from one location to another. In this case the IA Healthcare Service@Location record will be made defunct (non-current) and a new Healthcare Service@Location record will be created with a current status. In this scenario the captured referral guidelines in ARD can become "orphaned" as they are not attached to any current IA healthcare service.

Categories of non-current or orphaned referral guidelines: INDIVIDUAL and COMMON.
The REFERRAL GUIDELINES section of the profile has the prefix INDIVIDUAL or COMMON to help you choose the method below when transferring referral guidelines from a non-current Healthcare Service@Location to a current healthcare service@location.

Individual referral process
  1. Click on a non-current (Red) Healthcare Service@Location at the bottom of the All Locations list.
  2. The non-current referral info is displayed with the link Copy this Referral Process to another Healthcare Service@Location link on the upper right hand corner. Click on the copy link.
  3. Choose a current location (Green or Brown) from the All Locations list. This will be the Healthcare Service@Location you are pasting the referral info into.
  4. The system will display the Edit Referral Info screen populated with the referral info from the non-current Healthcare Service@Location you viewed in the first step.
  5. Click Save and the referral info is transferred from the non-current Healthcare Service@Location to the current one.
  6. Repeat these steps for each Healthcare Service@Location that needs attention.

Common referral process - 2 sub cases.
Case 1: At least 1 current Healthcare Service@Location with common referral info is with current status for this healthcare service; One or more Healthcare Healthcare Service@Locations where replaced by new one.
  1. Click on any current Healthcare Service@Location whether it has referral info (Green) or not (Brown).
  2. The healthcare service location opens in the Edit Referral Info screen populated with the current common referral info.
  3. Save it. 
  4. All locations will be updated with the common referral information, including all the locations that don't have referral info yet (Brown). The non-current referrals (Red) will also be updated.
Case 2:  All Healthcare Healthcare Service@Locations for a healthcare service are set to a non-current status and replaced by new ones. In this case there is no current additional referral info to copy from, so the only alternative is to pick up the non-current common referral process (Red). Follow the steps described in the section Individual Referral Process above to copy/paste the non-current common referral info to the current healthcare service locations.
Generally we want to replicate current common referral info to new or replaced healthcare service locations. We only resort to copying non-current common referral info if there is no other option.

Remember: Some fields can be location specific with the common referral process:
Parking Instructions, Directions, Parking Map, Wait Time, Referral Phone or Referral Fax.
To update these items you have to edit each Healthcare Service@Location separately.

ADDITONAL NOTES:
  • The info icon after the All Locations drop down will be visible to ARD Administrators.
  • The system doesn't allow you to copy referral information from one non-current Healthcare Service@Location to another.

 

V6.6