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Anticoagulation Management Services   at
Foothills Medical Centre
Connect Care Specialty: Anticoagulation
Connect Care Department: CGY FMC ANTICOAGULATION CL
Estimated time to routine appointment: Within 1 week
Alberta Health Services - Calgary Zone
SERVICE DESCRIPTION
Clinic staffed by pharmacists and nurses. Provides initiation of anticoagulation therapy and longterm monitoring of patients with high thrombotic or bleeding risk.Services include:
  • coordinating laboratory testing
  • dosing decisions for anticoagulation medicine
  • education
The service is in communication with the patient’s primary care doctor.
Clinic staffed by pharmacists and nurses. Provides initiation of anticoagulation therapy and longterm monitoring of patients with high thrombotic or bleeding risk.Services include:
  • coordinating laboratory testing
  • dosing decisions for anticoagulation medicine
  • education
The service is in communication with the patient’s primary care doctor.
ROUTINE REFERRAL PROCESS
When referring a pt please ensure to include diagnosis, reason for referral, duration of therapy, drug of choice, INR target range if applicable, referring physician signature and contact number.

Expected wait time to patient appointment is 1-3 business days.
Referrals from South Health Campus should be directed to Peter Lougheed Centre -CGY PLC ANTICOAGULATION CL

Referrals from Rockyview General Hospital should be directed to Foothills Medical Centre-CGY FMC ANTICOAGULATION CL.
Peri procedure bridging patients:  Will be seen 7-14 days prior to their procedure date.  If you need a Bridging Referral form, please call the clinic.
When referring a pt please ensure to include diagnosis, reason for referral, duration of therapy, drug of choice, INR target range if applicable, referring physician signature and contact number.

Expected wait time to patient appointment is 1-3 business days.
Referrals from South Health Campus should be directed to Peter Lougheed Centre -CGY PLC ANTICOAGULATION CL

Referrals from Rockyview General Hospital should be directed to Foothills Medical Centre-CGY FMC ANTICOAGULATION CL.
Peri procedure bridging patients:  Will be seen 7-14 days prior to their procedure date.  If you need a Bridging Referral form, please call the clinic.
URGENT REFERRAL PROCESS
  • Patient does NOT require same day treatment but needs to be seen SOONER than Routine.
  • Physician - please call AMS at 403-944-2784 and speak with a Clinician.  Explain reason for Urgency.
  • ALSO - Fax referral to 403-944-8174 and write "Urgent" at the top.
  • Includes perioperative bridging for MEDICALLY URGENT procedure <14 days from referral.
  • AMS does not offer same day appointments.  If the patient requires same day therapy,  direct patient to the Emergency department.
  • There is NO physician in clinic to assess the patient.  For Urgent medical consult,  please contact General Internal Medicine or Hematology on-call via ROCA
  • Patient does NOT require same day treatment but needs to be seen SOONER than Routine.
  • Physician - please call AMS at 403-944-2784 and speak with a Clinician.  Explain reason for Urgency.
  • ALSO - Fax referral to 403-944-8174 and write "Urgent" at the top.
  • Includes perioperative bridging for MEDICALLY URGENT procedure <14 days from referral.
  • AMS does not offer same day appointments.  If the patient requires same day therapy,  direct patient to the Emergency department.
  • There is NO physician in clinic to assess the patient.  For Urgent medical consult,  please contact General Internal Medicine or Hematology on-call via ROCA
EMERGENCY REFERRAL PROCESS
Direct patient to the nearest emergency department or Urgent care facility
  • Requires immediate medical assessment or treatment and initiation of anticoagulation therapy.
  • already on therapy and exhibits signs of clot extension/recurrence or clinically significant bleeding
Direct patient to the nearest emergency department or Urgent care facility
  • Requires immediate medical assessment or treatment and initiation of anticoagulation therapy.
  • already on therapy and exhibits signs of clot extension/recurrence or clinically significant bleeding
ELIGIBILITY REQUIREMENTS
  • AHS Anticoagulation referral form - complete in its entirety.  Please include diagnosis  reason for referral, duration of therapy, drug of choice, INR target range if applicable, referring physician signature and contact number.
  • Age 16 and older.  Younger patients may be referred to Alberta Children's Hospital
  • Patients must live within the Calgary Zone catchment area or remain in the Calgary zone for at least 7 days after referral
  • Referral initiated by Calgary Zone physician or Nurse Practitioner
  • Peritoneal dialysis or home nocturnal dialysis accepted.  Patients requiring In-Centre hemodialysis will have therapy managed by Nephrology
  • Patients in assisted living or SL4 units under the care of their primary physician accepted.  Patients in long term care facility using Anticoagulation Management algorithm will have therapy managed by facility.
  • patient or caregiver must have ongoing access to telephone/fax/ or email.
  • patient or caregiver must demonstrate capacity to understand the condition and implications of therapy
  • AHS Anticoagulation referral form - complete in its entirety.  Please include diagnosis  reason for referral, duration of therapy, drug of choice, INR target range if applicable, referring physician signature and contact number.
  • Age 16 and older.  Younger patients may be referred to Alberta Children's Hospital
  • Patients must live within the Calgary Zone catchment area or remain in the Calgary zone for at least 7 days after referral
  • Referral initiated by Calgary Zone physician or Nurse Practitioner
  • Peritoneal dialysis or home nocturnal dialysis accepted.  Patients requiring In-Centre hemodialysis will have therapy managed by Nephrology
  • Patients in assisted living or SL4 units under the care of their primary physician accepted.  Patients in long term care facility using Anticoagulation Management algorithm will have therapy managed by facility.
  • patient or caregiver must have ongoing access to telephone/fax/ or email.
  • patient or caregiver must demonstrate capacity to understand the condition and implications of therapy
ADDITIONAL SERVICE DETAILS
Approximate length of appointment time varies between 45-90 minutes, dependent on service required.  Patients are asked to have their provincial healthcare, photo ID, health insurance information, and a current list of all prescription and nonprescription medications with them for the appointments.  They are welcome to have a significant other present.  

Translation services are available.

**Closed on weekends and  all statutory holidays
 
Re:  Perioperative Bridging Patient:  These referrals are triaged closer to their procedure date.  Therefore,  communication of appointment details to patient and referral source will occur WITHIN 14 DAYS OF THE PROCEDURE DATE for these patients.

 

Approximate length of appointment time varies between 45-90 minutes, dependent on service required.  Patients are asked to have their provincial healthcare, photo ID, health insurance information, and a current list of all prescription and nonprescription medications with them for the appointments.  They are welcome to have a significant other present.  

Translation services are available.

**Closed on weekends and  all statutory holidays
 
Re:  Perioperative Bridging Patient:  These referrals are triaged closer to their procedure date.  Therefore,  communication of appointment details to patient and referral source will occur WITHIN 14 DAYS OF THE PROCEDURE DATE for these patients.

 

COMMUNICATION PROCESS
  • Communication of referral receipt to referral source will occur within 1 calendar days.
  • Communication of appointment details or wait list status to patient and referral source will occur within 1 calendar days.
  • Communication of initial appointment outcomes to referral source will occur within 1 calendar days.
 
PHONE
403-944-2784 (Clinical Contact)
FAX
403-944-8174
REFERRAL PHONE
403-944-2784
REFERRAL FAX
403-944-8174
REFERRAL FORM
If you have access to Connect Care, please refer directly to
Connect Care - CGY FMC ANTICOAGULATION CL
For those with no Connect Care access please use the form below:
Anticoagulation Management Services Referral Form
If you have access to Connect Care, please refer directly to
Connect Care - CGY FMC ANTICOAGULATION CL
For those with no Connect Care access please use the form below:
Anticoagulation Management Services Referral Form
LINKED SPECIALISTS
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
Timing
Additional Details
+-
Atrial fibrillation and flutter
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Cardiology consult notes
 
Most recent
ECG
 
Within 1 month
Holter monitor report - if completed
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
Current
Emergency referral if patient in cardiorespiratory distress or requires immediate cardiac assessment or urgent cardioversion
+-
Cardioembolic stroke
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Cardiology/Stroke clinic consult notes
 
Most recent
Head CT - if available
 
Within 1 month
Hospital discharge summary if not available in Netcare
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
Current
  • Includes TIA
  • Patient to be seen in Emergency department if new onset of symptoms



+-
Management of anticoagulant
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Diagnostic Imaging as Pertinent (VTE, cardiac)
 
Within 3 months
Emergency chart - if applicable
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Mimimum of last 3 INR results with corresponding dosage record
 
Within 2 months
Pregnancy: Estimated date of delivery
 
Current
Reason for transition of anticoagulant agent
 
Current
Summary of bleeding events and therapy, including CBC at nadir
 
Within 3 months
Weight
 
Current
A)  Full treatment dosage anticoagulation in pregnancy.   No prophylactic dosing please.  Patient should also be referred to Obstetric Internal Medicine Clinic  (ROCA)
B)  Instability of anticoagulation therapy in High risk patient
  • failure of anticoagulant agent
  • bleeding
  • Pattern of unstable INR
  • Transition from Direct Oral Anticoagulant to Warfarin
 
+-
Myocardial dysfunction
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Cardiac consult notes - if available
 
Most recent
Echocardiogram
 
Within 3 months
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
current
Left ventricular dysfunction with Ejection fraction  <20%
+-
Myocardial infarction
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Cardiology consult notes - if availabe
 
Most recent
Coronary angiogram - if available
 
Within 1 month
Echocardiogram
 
Within 1 month
Emergency chart - if applicable
 
Within 2 weeks
Hospital discharge if unavailable in Netcare
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
Current
  • Large anterior myocardial infarction
  • Within initial 4 weeks post event
+-
Perioperative care
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Date and Type of Surgical Procedure
 
Current
INR Target range
 
Current
Reason for anticoagulation therapy
 
Current
Required: Completion of Periprocedural Management of Anticoagulation Order Sheet - in its entirety (all fields, physician signature. If you require this referral form, please contact the clinic.
 
Current
Weight
 
Current
Periprocedural Bridging
Orders for non-urgent procedures should be faxed no less than 14 days prior to procedure.  If you require guidance to complete bridging orders, please call the clinic at 403-943-5584 to speak to a clinician.
For medically Urgent procedures <14 days from receipt of referral,  physician to call AMS to speak to a clinician in addition to faxing bridging referral.
AMS does NOT provide bridging for patients on DOAC.
+-
Pulmonary embolism
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
D-dimer
 
Within 1 week
Diagnostic imaging confirming diagnosis - if completed: V/Q scan, CT chest
 
Within 1 month
Emergency chart - if applicable
 
Within 2 weeks
Hospital discharge summary if not available in Netcare
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
Current
Direct patient to Emergency if immediate medical assessment or treatment is needed.
  • New diagnosis
  • recurrence of symptoms

+-
Pulmonary hypertension
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Diagnostic imaging -if applicable (CT chest, V/Q scan
 
Within one year
Echocardiogram
 
Within 3 months
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Respirology/Internal medicine consult notes - if available
 
Most recent
Right Heart Catheterization results - if completed
 
Within 3 months
Weight
 
Current
Includes Chronic Thromboembolic Pulmonary Hypertension

+-
Thromboembolic disorder
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
D-dimer
 
Within 1 week
Emergency chart - if applicable
 
Within 2 weeks
Hospital discharge summary if not available in Netcare
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Thrombophilia testing results
 
diagnostic
Weight
 
Current
diagnostic imaging confirming diagnosis - Ultraound, angiogram
 
Within 1 month
  • Includes venous thromboembolism
  • arterial embolism 
  •  superficial vein thrombosis
Direct patient to Emergency if immediate medical assessment or treatment is needed

+-
Valvular heart disease
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Cardiology consult notes - if available
 
Within 6 months
Echocardiogram
 
Within 6 months
Hospital discharge if unavailable in Netcare
 
Within 1 month
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Weight
 
Current
If patient has a prosthetic valve:
  • Please indicate position, type, and insertion date of valve prosthetic
  • Please ensure INR target range is clearly identified
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
  • If patient misses first scheduled intake appointment without notifying the clinic, staff will investigate to understand reason why.  AMS will work with the referring physician to ensure that anticoagulation treatment is arranged for the patient, and another appointment is offered.
  • If the patient missed the second scheduled intake appointment without notice, the referring physician will be notified.  The referral will be reassess but only declined with the agreement of the referring physician.
  • If the patient misses the third appointment, the referral will be declined.
  • If patient misses first scheduled intake appointment without notifying the clinic, staff will investigate to understand reason why.  AMS will work with the referring physician to ensure that anticoagulation treatment is arranged for the patient, and another appointment is offered.
  • If the patient missed the second scheduled intake appointment without notice, the referring physician will be notified.  The referral will be reassess but only declined with the agreement of the referring physician.
  • If the patient misses the third appointment, the referral will be declined.
 
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
   
 
ADDRESS
Located in the Special Services Building
1403 29 Street NW
Calgary Alberta
T2N 2T9
PATIENT APPOINTMENT INSTRUCTIONS
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
 
DIRECTIONS
The Anticoagulation Management Service is located in the Special Services Building.  Directions will be provided at the time of appointment booking.

Foothills Medical Centre is located at the intersection of 16 Avenue NW and 29 Street NW.

Transit:
Public transportation is available to this facility.
The Anticoagulation Management Service is located in the Special Services Building.  Directions will be provided at the time of appointment booking.

Foothills Medical Centre is located at the intersection of 16 Avenue NW and 29 Street NW.

Transit:
Public transportation is available to this facility.
 
PHONE
403-944-2784 (Clinical Contact)
 
PARKING INSTRUCTIONS

The new Central Parking is now open to patients, families and visitors. Public parking is available on the Skyline (second level at grade) and Mountain levels (third level) with an additional level opening in the coming months.
Most public parking at Foothills Medical Centre will be in the new Central Parking, but there are two other public parking lots for your convenience: West Parking (Lot 10) and North Parking (Lot 6).

The new Central Parking is now open to patients, families and visitors. Public parking is available on the Skyline (second level at grade) and Mountain levels (third level) with an additional level opening in the coming months.
Most public parking at Foothills Medical Centre will be in the new Central Parking, but there are two other public parking lots for your convenience: West Parking (Lot 10) and North Parking (Lot 6).

 
EMAIL
VIRTUAL APPOINTMENT INFORMATION
 
 
WHEELCHAIR ACCESSIBILITY
Yes

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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