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Otolaryngology Centralized Access - Facilitated Access to Specialized Treatment (FAST)   at
North Zone and Area
Central Access Healthcare Service
Specialty: Otolaryngology
Estimated time to routine appointment: Not Available
Alberta Health Services - North Zone
CENTRAL ACCESS SERVICES
Referrals for Otolaryngology in the North Zone are accepted through the Facilitated Access to Specialized Treatment (FAST) centralized access program. The program improves patient access to specialty care by centralizing referral intake, ensuring referrals are complete, and distributing referrals to specialists. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider.
Referrals for Otolaryngology in the North Zone are accepted through the Facilitated Access to Specialized Treatment (FAST) centralized access program. The program improves patient access to specialty care by centralizing referral intake, ensuring referrals are complete, and distributing referrals to specialists. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider.
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
Complete the referral form or letter and fax it to the service using the contact information in this profile.  Please include the mandatory information listed in the Otolaryngology Adult Referral Pathway.
OR
Submit referral via Alberta Netcare eReferral – see Quick Reference Guide for details.
Complete the referral form or letter and fax it to the service using the contact information in this profile.  Please include the mandatory information listed in the Otolaryngology Adult Referral Pathway.
OR
Submit referral via Alberta Netcare eReferral – see Quick Reference Guide for details.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Use an Outgoing Referral in Connect Care.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in work queue 5.
Use an Outgoing Referral in Connect Care.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in work queue 5.
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.
 
CENTRAL ACCESS REFERRAL PHONE
1-833-553-3278 ext 1
CENTRAL ACCESS REFERRAL FAX
1-833-627-7025
REFERRAL FORMS
PATHWAYS
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
+-
Acute otitis media
Audiogram
  • Note: must request “full diagnostic audiological assessment” (screening not sufficient)
 
N/A
Include the following information in the referral letter:
  • Tinnitus (right/left/none)
  • Draining ear (right/left/none)
  • Ear pain (right/left/none) (describe characteristics)
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Previous history of head trauma or concussion
  • History of Temporomandibular joint disorder (ear pain only)
 
N/A
Assessment results should support the reason for referral i.e. tympanogram shows a type B pattern, which is consistent with “middle ear effusion”; increased ear canal volume inconsistent with “tympanic membrane perforation”
 
N/A
Acute Otitis Media
• recurrent >3 episodes in 6 months

Send referral to North Zone FAST Team.
+-
Change in voice
Smoking History
 
N/A
If available:
  • Swallowing difficulties
  • Speech Language Pathology documentation>/li>
 
N/A
Change in Voice
• Persistent dysphonia >4 weeks
  • Send referral to North Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
+-
Chronic airway obstruction
If available:
  • Exercise tolerance
  • Pulmonary function test
 
N/A
Chronic Airway Obstruction 
• i.e. inspiratory stridor
  • Send referral to North Zone FAST Team.
+-
Chronic tonsillitis
N/A
 
N/A
Chronic Tonsillitis
• >12 weeks
• i.e. symptomatic tonsil stones, halitosis, chronic sore throat

Send referral to North Zone FAST Team.
+-
Disorder of eyelid
N/A
 
N/A
Disorder Of Eyelid 
• Facial paralysis post-cancer treatment, excessive upper eyelid skin, ptotic brows, ectropion, etc.
  • Send referral to North Zone FAST Team.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Disorder of salivary gland
If available:Ultrasound
 
N/A
Disorder of The Salivary Gland 
• i.e. stones, inflammation

Send referral to North Zone FAST Team.
+-
Drainage from external ear canal
Audiogram (tinnitus and ear fullness/pressure only)
  • Note:must request “full diagnostic audiological assessment” (screening is not sufficient)
 
N/A
Include the following information in the referral letter:
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Hearing loss
  • History of ear infection
  • Vertigo
  • Ear Pain
 
N/A
If available: Audiogram (discharge from the ear)
 
N/A
Drainage From External Ear Canal
• >3 months or unresponsive to treatment
  • Send referral to North Zone FAST Team.
+-
Dysphagia
If available:
  • Include description of disease progression
  • Imaging results
  • Allied health reports (i.e. clinical dysphagia assessments)
 
N/A
Dysphagia
  • Send referral to North Zone FAST Team (for otolaryngology or general surgery.)
+-
Ear deformity
N/A
 
N/A
Ear Deformity
  • Send referral to North Zone FAST Team.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Ear pain
Audiogram
  • Note: must request “full diagnostic audiological assessment” (screening not sufficient)
 
N/A
Include the following information in the referral letter:
  • Tinnitus (right/left/none)
  • Draining ear (right/left/none)
  • Ear pain (right/left/none) (describe characteristics)
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Previous history of head trauma or concussion
  • History of Temporomandibular joint disorder (ear pain only)
 
N/A
Assessment results should support the reason for referral i.e. tympanogram shows a type B pattern, which is consistent with “middle ear effusion”; increased ear canal volume inconsistent with “tympanic membrane perforation”
 
N/A
Ear Pain 
Otalgia persistent >4 weeks or progressive or severe
  • Send referral to North Zone FAST Team.
+-
Ear pressure sensation
Audiogram (tinnitus and ear fullness/pressure only)
  • Note:must request “full diagnostic audiological assessment” (screening is not sufficient)
 
N/A
Include the following information in the referral letter:
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Hearing loss
  • History of ear infection
  • Vertigo
  • Ear Pain
 
N/A
If available: Audiogram (discharge from the ear)
 
N/A
Ear Pressure Sensation 
Includes ear fullness, eustachian tube dysfunction
  • Send referral to North Zone FAST Team.
+-
Epistaxis
N/A
 
N/A
Epistaxis 
• failed conservative treatment

Send referral to North Zone FAST Team.
+-
Facial deformity
If available:Clinical photograph
 
N/A
Facial Deformity 
Includes: facial injury and facial scar
  • Send referral to North Zone FAST Team.
  • Facial bone fractures: refer to plastic surgery or oral and maxillofacial surgery referral pathways.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Facial nerve paralysis
N/A
 
N/A
Facial Nerve Paralysis 
• Acute <10 days 
call RAAPID or request non-urgent phone advice.
Any suspicion of stroke, send to Emergency Department via 911.

• Chronic Facial Palsy >10 days
Send referral to North Zone FAST Team.
Initial consultations are insured. Procedures may or may not be insured. Please indicate if the patient is unable to protect their eye to assist with clinical triage.
+-
Foreign body in ear
N/A
 
N/A
Foreign Body in Ear

Call RAAPID 1-800-282-9911 or request non-urgent phone advice.
+-
Fracture of nasal bones
N/A
 
N/A
Fracture of Nasal Bone

• ≤7 days-URGENT REFERRAL: Call Surgeon on Call through RAAPID 1-800-282-9911.
• >7 days: See Nasal Deformity Reason for Referral
+-
Globus sensation
If available, include the following information if relevant:
  • Dysphagia
  • Painful Swallowing
  • History of reflux
  • Reflux symptoms
  • Voice changes
  • Investigations done (i.e. Barium swallow, modified barium swallow (Videofluoroscopic swallow study), CT Neck, Ultrasound neck)
 
N/A
Globus Sensation
  • Send referral to North Zone FAST Team.
+-
Hearing loss
Audiogram
  • Note: must request “full diagnostic audiological assessment” (screening not sufficient)
 
N/A
Include the following information in the referral letter:
  • Tinnitus (right/left/none)
  • Draining ear (right/left/none)
  • Ear pain (right/left/none) (describe characteristics)
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Previous history of head trauma or concussion
  • History of Temporomandibular joint disorder (ear pain only)
 
N/A
Assessment results should support the reason for referral i.e. tympanogram shows a type B pattern, which is consistent with “middle ear effusion”; increased ear canal volume inconsistent with “tympanic membrane perforation”
 
N/A
Hearing Loss - not sudden
  • Send referral to North Zone FAST Team.
  • Note: Sudden hearing loss should be treated within 14 days of onset. Order urgent audiogram to facilitate corticosteroid treatment within 14 days of onset. Call RAAPID or request non-urgent phone advice
+-
Lesion of ear canal
N/A
 
N/A
Lesion of Ear Canal

Send referral to North Zone FAST Team.
+-
Lesion of mouth and/or pharynx
Extra information if available:
  • Significant weight loss due to pain with eating and swallowing
 
N/A
Lesion of Mouth and/or Pharynx 
• i.e. mucocele, leukoplakia, tonsil lesion, tongue lesion, ulcer
  • Send referral to North Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
+-
Mass of soft tissue
N/A
 
N/A
Mass of Soft Tissue 
• head and neck mass or lesion (i.e. cyst, lipoma)
  • Send referral to North Zone FAST Team.
  • If neck mass, consider ultrasound
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
+-
Middle ear effusion
Audiogram
  • Note: must request “full diagnostic audiological assessment” (screening not sufficient)
 
N/A
Include the following information in the referral letter:
  • Tinnitus (right/left/none)
  • Draining ear (right/left/none)
  • Ear pain (right/left/none) (describe characteristics)
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Previous history of head trauma or concussion
  • History of Temporomandibular joint disorder (ear pain only)
 
N/A
Assessment results should support the reason for referral i.e. tympanogram shows a type B pattern, which is consistent with “middle ear effusion”; increased ear canal volume inconsistent with “tympanic membrane perforation”
 
N/A
Middle Ear Effusion 
• persistent >3 months

Send referral to North Zone FAST Team.
+-
Nasal deformity
N/A
 
N/A
Nasal Deformity 
• Includes: reconstruction, septoplasty and rhinoplasty
  • Send referral to North Zone FAST Team.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Nasal mass
N/A
 
N/A
Nasal Mass
+-
Nasal obstruction
If available:
  • History, physical exam findings and treatments attempted
 
N/A
Nasal Obstruction 
• i.e. deviated nasal septum, nasal polyps, unilateral nasal obstruction

Send referral to North Zone FAST Team.

If available:
• History, physical exam findings and treatments attempted
+-
Obstructive sleep apnea
History of CPAP
 
N/A
Sleep Study showing moderate to severe findings
 
N/A
Obstructive Sleep Apnea 
• Moderate to Severe OSA with failed CPAP treatment warranting surgical consideration
+-
Otolaryngology surgery consultation
N/A
 
N/A
Consult For Otolaryngology

Send referral to North Zone FAST Team
+-
Recurrent acute tonsillitis
If available:
  • Relevant hospitalization
  • Treatment history
 
N/A
Throat swab history
 
N/A
Recurrent Acute Tonsillitis
  • Send referral to North Zone FAST Team.
+-
Rhinitis
Failed nasal corticosteroid trail
 
4-6 weeks
Rhinitis 
• failed conservative treatment, i.e. nasal discharge/post-nasal drip/nasal stuffiness
+-
Salivary gland mass
If available:Ultrasound
 
N/A
Salivary Gland Mass
  • Send referral to North Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
+-
Sense of smell impaired
CT sinus ordered
 
N/A
Smell Dysfunction
• > 12 weeks
• i.e. anosmia, hyposmia, phantosmia
  • Send referral to Zone FAST Team
+-
Sinusitis
CT sinus ordered
 
N/A
Sinusitis 
• Rhinosinusitis
  • Refer to the CLINICAL PATHWAY: RHINOSINUSITIS to help guide the care of your patient prior to referral.
  • If symptoms persist after completing the Rhinosinusitis clinical pathway, send referral to North Zone FAST Team.
  • Extra info:
    • Chronic sinusitis is confirmed when there is evidence of sinusitis on the CT scan. If the CT scan does not show evidence of sinusitis, see the rhinitis reason for referral
    • Sinus x-rays are not an effective diagnostic test for this condition.
+-
Skin cancer
N/A
 
N/A
Skin Cancer 
• Head and neck

Send referral to North Zone FAST Team or Dermatology as per zonal processes.
+-
Suspected head and neck cancer
List high risk symptoms
 
N/A
If available: CT neck ordered with contrast (indicate ordered in referral letter) but do not delay referral while waiting for CT scan.
 
N/A
Suspected Head And Neck Cancer 
• neck lump or facial mass
• oral and oropharyngeal mass or ulcer
• persistent hoarseness with history of tobacco and/or alcohol use
+-
Suspected parathyroid disease
Serum calcium, PTH
 
Within 6 months of referral
Suspected Parathyroid Disease 
• Hypercalcemia or elevated PTH or incidental imaging finding
  • Send referral to Zone FAST Team.
+-
Thyroid mass
  • TSH
  • Thyroid Ultrasound
 
Within 1 year of referral
Fine needle aspiration if recommended based on imaging and availability
 
N/A
Thyroid Mass

Send referral to North Zone FAST Team.
+-
Tinnitus
Audiogram (tinnitus and ear fullness/pressure only)
  • Note:must request “full diagnostic audiological assessment” (screening is not sufficient)
 
N/A
Include the following information in the referral letter:
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Hearing loss
  • History of ear infection
  • Vertigo
  • Ear Pain
 
N/A
If available: Audiogram (discharge from the ear)
 
N/A
Tinnitus 
• Consider referral for the following: unilateral tinnitus with associated hearing loss, or pulsatile

Send referral to North Zone FAST Team.
+-
Tympanic membrane perforation
Audiogram
  • Note: must request “full diagnostic audiological assessment” (screening not sufficient)
 
N/A
Include the following information in the referral letter:
  • Tinnitus (right/left/none)
  • Draining ear (right/left/none)
  • Ear pain (right/left/none) (describe characteristics)
  • Otoscopy (normal/abnormal)
  • Previous ear procedures/surgery (right/left and details)
  • Previous history of head trauma or concussion
  • History of Temporomandibular joint disorder (ear pain only)
 
N/A
Assessment results should support the reason for referral i.e. tympanogram shows a type B pattern, which is consistent with “middle ear effusion”; increased ear canal volume inconsistent with “tympanic membrane perforation”
 
N/A
Tympanic Membrane Perforation 
• >3 months duration

Send referral to North Zone FAST Team.
+-
Vertigo
Audiogram showing signs of hearing loss
  • Note:must request “full diagnostic audiological assessment” (screening isnot sufficient)
 
N/A
Documentation of ear symptoms (i.e. tinnitus, ear pain)
 
N/A
If available:Assessment report and treatment response from vestibular physiotherapist
 
N/A
Vertigo 
• with ear symptoms, i.e. hearing loss and ear pain


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.

 

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