Pediatric Cleft Lip and Palate Clinic   at
Alberta Children's Hospital
Connect Care Specialty: Pediatric Plastic Surgery Connect Care Department: CGY ACH CLEFT PALATE CL
Alberta Health Services - Calgary Zone





Estimated time to routine appointment: Within 3 months
SERVICE DESCRIPTION
Offers care for children and adults born with a cleft lip and/or palate and other head, face, or jaw abnormalities.
Provides care to children and adults born with a cleft lip and/or palate and other head, face, or jaw abnormalities, which includes follow-up care with healthcare providers.
Offers care to children with hypernasal speech (too much air coming down the nose during speech, also known as velopharyngeal dysfunction).
Visit the PEAS (Pediatric Eating and Swallowing) website to find relevant information for families and care providers of children with an eating, feeding and swallowing disorder.
EMERGENCY REFERRAL PROCESS
This service does not have an emergency referral process. Concerns of serious illness or injury should be directed to go to the nearest Emergency Department. Patients with potentially life threatening conditions should immediately phone 9-1-1.
This service does not have an emergency referral process. Concerns of serious illness or injury should be directed to go to the nearest Emergency Department. Patients with potentially life threatening conditions should immediately phone 9-1-1.
URGENT REFERRAL PROCESS
Please indicate on referral if "urgent" and fax complete referral form to number indicated below.  Call clinic to discuss.
Please indicate on referral if "urgent" and fax complete referral form to number indicated below.  Call clinic to discuss.
ROUTINE REFERRAL PROCESS
Fax complete referral form to number indicated below.
Patients (newborns) are typically seen within 2 weeks.
Patients under 1 year of age are typically seen within 1 month.
Patients over 1 year of age are typically seen within 2-3 months.
Fax complete referral form to number indicated below.
Patients (newborns) are typically seen within 2 weeks.
Patients under 1 year of age are typically seen within 1 month.
Patients over 1 year of age are typically seen within 2-3 months.
ELIGIBILITY REQUIREMENTS
We accept the following referring diagnosis (please specifiy on referral form):
  • cleft lip
  • cleft lip and cleft palate
  • cleft palate
  • submucous cleft palate
  • velopharyngeal dysfunction (hypernasality/nasal tone to voice and/or nasal air escape during speech) for patients over 18 months to < 18 years of age ONLY. PLEASE NOTE: Patients >18 years of age should be referred to adult programs.
Please also specific age cohort on referral form: 
  • antenatal referral
  • newborn referral (birth to 28 days)
  • infant referral (28 days to 1 years)
  • child referral (1 year to 18 years)
  • adult referral (18 years and over for cleft lip/palate patients ONLY)
We accept the following referring diagnosis (please specifiy on referral form):
  • cleft lip
  • cleft lip and cleft palate
  • cleft palate
  • submucous cleft palate
  • velopharyngeal dysfunction (hypernasality/nasal tone to voice and/or nasal air escape during speech) for patients over 18 months to < 18 years of age ONLY. PLEASE NOTE: Patients >18 years of age should be referred to adult programs.
Please also specific age cohort on referral form: 
  • antenatal referral
  • newborn referral (birth to 28 days)
  • infant referral (28 days to 1 years)
  • child referral (1 year to 18 years)
  • adult referral (18 years and over for cleft lip/palate patients ONLY)
REFERRAL FORM
Referral Form

In addition, we require the following information with EVERY referral. We will NOT process a referral without parent/guardian names and contact details:

ANTENNAL REFERRAL:
  • diagnosis and due date
  • relevant history eg. previous pregnancies, genetic
Referral Form

In addition, we require the following information with EVERY referral. We will NOT process a referral without parent/guardian names and contact details:

ANTENNAL REFERRAL:
  • diagnosis and due date
  • relevant history eg. previous pregnancies, genetic testing results from amniocentesis
  • IF termination is a consideration, please mark URGENT on referral
  • We will NOT process a referral without parent/guardian names and contact details  
NEWBORN REFERRAL (birth to 28 days):
  • Delivery record/notice of birth REQUIRED to process referral
  • Feeding information: feeding method, volume of feed and frequency
  • Additional concerns eg. parental anxiety, medical complications, additional diagnosis, etc.
  • Fetal echo, genetic testing results from amniocentesis
  • Newborn hearing screen results 
 INFANT REFERRAL (28 days to 1 year):
  • Birth weight REQUIRED to process referral
  • Growth chart
  • Feeding information, feeding method, volume of feeds and frequency 
CHILD OR ADULT REFERRAL:
  • Medical history and any relevant reports eg. speech language pathology
... More Hide
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
Timing
Additional Details
Antenatal ultrasound finding
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Cleft lip
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Cleft palate
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Cleft palate with cleft lip
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Goldenhar syndrome
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Hemifacial microsomia
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Treacher Collins syndrome
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable

Velopharyngeal insufficiency
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

If newborn; include delivery records
| If applicable
ADDITIONAL SERVICE DETAILS
The following Pediatric Dentists, Orthodontists and Oral Surgeons are affiliated with our clinic;
  • Dr. Darrel Kemp (Orthodontist)
  • Dr. Kevin Robertson (Oral Surgeon)
  • Dr. Jennifer Smith (Orthodontist)
  • Dr. Miller Smith (Oral Surgeon)


COMMUNICATION PROCESS
Communication of referral receipt to referral
source will occur within 7 calendar days.
 
Communication of appointment details or wait list status to patient and referral
source will occur within 14 calendar days.
 
Communication of initial appointment outcomes to referral
source will occur within 30 calendar days.
 
MISSED APPOINTMENT GUIDELINES
Missed appointments are minimized by requiring a re-referral after two missed appointments. (Alberta Children's Hospital Outpatient Principles in Practice, 6.8)
Missed appointments are minimized by requiring a re-referral after two missed appointments. (Alberta Children's Hospital Outpatient Principles in Practice, 6.8)
DIRECTIONS
Alberta Children's Hospital is located on the corner of 24 Avenue NW and West Campus Drive NW.
Alberta Children's Hospital is located on the corner of 24 Avenue NW and West Campus Drive NW.
PARKING INSTRUCTIONS
ADDRESS
Level 2 - Sensory Clinic Area
28 Oki Drive NW
Calgary Alberta
T3B 6A8
HOURS OF OPERATION
Monday: 8:00 am - 4:00 pm
Tuesday: 8:00 am - 4:00 pm
Wednesday: 8:00 am - 4:00 pm
Thursday: 8:00 am - 4:00 pm
Friday: 8:00 am - 4:00 pm
   
WHEELCHAIR ACCESSIBILITY
Yes

Main entrance

Lifts accessible onsite


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

The locations listed have 3 background colors:
  • Green means the service@location has referral information attached to it.
  • Brown means the service@location never had referral information attached to it, or it has unpublished referral information.
  • Red means
    • IA changed the service@location's status to something other than Current
    • It was deleted if it is an ARD service@location.
Green  and Brown are always at the top of the list. These are the Service@Locations with the status of Current.
The Red list at the bottom consists of non-current Service@locations that once had Published referral information in the ARD.
If the referral information was never published in ARD the 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 Service@Locations to ones that are current.

Common Scenario:
A Service moves from one location to another. In this case the IA Service@Location record will be made defunct (non-current) and a new 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 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 Service@Location to a current service@location.

Individual referral process
  1. Click on a non-current (Red) 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 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 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 Service@Location you viewed in the first step.
  5. Click Save and the referral info is transferred from the non-current Service@Location to the current one.
  6. Repeat these steps for each Service@Location that needs attention.

Common referral process - 2 sub cases.
Case 1: At least 1 current Service@Location with common referral info is with current status for this service; One or more Service@Locations where replaced by new one.
  1. Click on any current Service@Location whether it has referral info (Green) or not (Brown).
  2. The 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 Service@Locations for a 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 service locations.
Generally we want to replicate current common referral info to new or replaced 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 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 Service@Location to another.

 

V4.13