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Antenatal Community Care Program   at
East Calgary Health Centre
Specialty: Public Health and Preventive Medicine
Connect Care Department: CGY ECHC PH ACCP
Estimated time to routine appointment: Within 1 week
Alberta Health Services - Calgary Zone
SERVICE DESCRIPTION
A community nursing program that offers 7 days a week, in-home or clinic when appropriate for pregnant patient monitoring, and fetal health surveillance to those with high-risk pregnancies that are medically stable.Services include:
  • daily (physical and psychosocial) assessment of patients in their homes or over the telephone
  • fetal monitoring (non-stress tests) as ordered on referral
  • 1:1 perinatal education and teaching about their high-risk pregnancy condition(s), and other health concerns
  • teaching is provided about self-monitoring and when to seek urgent / emergent medical care
  • nutrition services are offered 1:1 for general nutrition, weight issues, special diets, supplement review and food security issues
  • referrals to community support resources as needed
  • closed loop communication with the Most Responsible Healthcare provider (MRHP)
This service provides in home care for antenatal patients who might otherwise be cared for in hospital. Patients remain under the care of their own obstetrician, or family physician, or midwife (with OB consult).

See Appendix F: ACCP Only - Routine Nursing Standards, Prenatal Nursing Practice Manual for routine Antenatal Community Care Program (ACCP) care.
A community nursing program that offers 7 days a week, in-home or clinic when appropriate for pregnant patient monitoring, and fetal health surveillance to those with high-risk pregnancies that are medically stable.Services include:
  • daily (physical and psychosocial) assessment of patients in their homes or over the telephone
  • fetal monitoring (non-stress tests) as ordered on referral
  • 1:1 perinatal education and teaching about their high-risk pregnancy condition(s), and other health concerns
  • teaching is provided about self-monitoring and when to seek urgent / emergent medical care
  • nutrition services are offered 1:1 for general nutrition, weight issues, special diets, supplement review and food security issues
  • referrals to community support resources as needed
  • closed loop communication with the Most Responsible Healthcare provider (MRHP)
This service provides in home care for antenatal patients who might otherwise be cared for in hospital. Patients remain under the care of their own obstetrician, or family physician, or midwife (with OB consult).

See Appendix F: ACCP Only - Routine Nursing Standards, Prenatal Nursing Practice Manual for routine Antenatal Community Care Program (ACCP) care.
ELIGIBILITY REQUIREMENTS
  • Must be referred by a physician
The patient must meet the program admission criteria as stated below and the charge nurse will determine acceptance to the program.

Patients must:
  • be stable with reassuring fetal/maternal status and normal NST
  • have a medically high-risk pregnancy condition that meets admission criteria as stated below
  • not work outside of their home
  • have access to a working telephone or cell phone
  • reside within Calgary and surrounding area
  • have an OB consult and referred by Most Responsible Healthcare Provider (MRHP)
  • be willing/able to participate in the program
  • Must be referred by a physician
The patient must meet the program admission criteria as stated below and the charge nurse will determine acceptance to the program.

Patients must:
  • be stable with reassuring fetal/maternal status and normal NST
  • have a medically high-risk pregnancy condition that meets admission criteria as stated below
  • not work outside of their home
  • have access to a working telephone or cell phone
  • reside within Calgary and surrounding area
  • have an OB consult and referred by Most Responsible Healthcare Provider (MRHP)
  • be willing/able to participate in the program
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 ACCP referral form and the Antenatal Home Visit Order set (side A & B) and fax it to the service using the contact information in this profile.

All faxed referrals must include prenatal records.

Call ACCP using the contact information in this profile to discuss the referral with the charge nurse. Outside of regular business hours please leave a voicemail to notify of referral.
Complete the ACCP referral form and the Antenatal Home Visit Order set (side A & B) and fax it to the service using the contact information in this profile.

All faxed referrals must include prenatal records.

Call ACCP using the contact information in this profile to discuss the referral with the charge nurse. Outside of regular business hours please leave a voicemail to notify of referral.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Population & Public Health, type CGY ECHC PH ACCP in the “To Department” section and complete order.  

AND

Submit an Antenatal Home Monitoring Order Set in Connect Care
Send an Internal Referral using the Ambulatory Referral Order to Population & Public Health, type CGY ECHC PH ACCP in the “To Department” section and complete order.  

AND

Submit an Antenatal Home Monitoring Order Set in Connect Care
ADDITIONAL SERVICE DETAILS
  • Regular business hours are 08:30 - 16:30, 7 days a week.
  • If after hours, ACCP will contact the referral source the following day to confirm acceptance to the program. If a referral is declined the referral source will be informed via fax and telephone.
  • Regular business hours are 08:30 - 16:30, 7 days a week.
  • If after hours, ACCP will contact the referral source the following day to confirm acceptance to the program. If a referral is declined the referral source will be informed via fax and telephone.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 2 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 2 days.
  • Wait list status update every 2 days.
  • Appointment outcome to referral source within 2 days.
 
PHONE
403-955-1210
403-944-7200
811 (immunization appointments only)
FAX
403-955-1211
REFERRAL PHONE
403-955-1210 ACCP
REFERRAL FAX
403-955-1211
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
Investigation Timing
Additional Details
+-
Antenatal fetal health surveillance
24 weeks gestation; NSTs start at 28 weeks' gestation
 
Current
Condition requires fetal surveillance (see additional details)
 
Current
Ultrasonography of abdomen and fetal biophysical profile
 
Current
Referral will be accepted for conditions requiring fetal surveillance. Examples may include, but are not limited to: Oligohydramnios, IHCP, abnormal dopplers, SGA/IUGR, uncomplicated decels in the hospital requiring repeated NSTs, complicated Monochorionic twins, previous stillbirth and decreased fetal movement.
If biophysical profile is < 6/8 referral to be discussed with Medical Director.
+-
Antepartum hemorrhage
24 weeks gestation; NSTs start @ 28 weeks' gestation
 
Current
In the hospital for >=48 hours
 
Current
Consult with Obstetrician
 
Current
More than 3 significant episodes of bleeding will be discussed with the Medical Director
 
Current
Significant episodes of bleeding requires hospital admission.
+-
Complications specific to multiple gestation
Secondary diagnosis of multiple gestation, with primary diagnosis of any other reason for referral
 
Current
Must still meet the referral guidelines for primary diagnosis.
+-
Diabetes mellitus
Secondary diagnosis of diabetes, primary diagnosis of any other reason for referral
 
Current
Poor glycemic control
 
Current
Must still meet the referral guidelines for primary diagnosis.
Self care criteria are set by the Diabetes in Pregnancy Clinic.
+-
Gestational diabetes mellitus
Secondary diagnosis of diabetes, primary diagnosis of any other reason for referral
 
Current
Poor glycemic control
 
Current
Must still meet the referral guidelines for primary diagnosis.
Self care criteria are set by the Diabetes in Pregnancy Clinic.
+-
Hypertensive disorder
20 weeks' gestation; NSTs start at 28 weeks' gestation
 
Current
Abnormal hypertension labs will be discussed with referring physician
 
Current
Blood pressure >140/90 on two separate occasions at least 6 hours apart and/or elevated BP while on medications
 
Current
No acute deterioration in lab values
 
Current
Worsening symptoms of hypertension in pregnancy should be assessed and treated in hospital.
Please note, patient is taught to self-monitor blood pressure 4 times per day.

Labwork is processed by physician orders. Please ensure to enter orders on the Order Set.
+-
Placenta previa
24 weeks gestation; NSTs start @ 28 weeks' gestation
 
Current
Resolution of bleeding for minimum 48 hours
 
Current
More than 3 significant episodes of bleeding will be discussed with the Medical Director
 
Current
Cervical length >= 2cm
 
Current
Must not have Vasa Previa
 
Current
Any bleeding prior to 24 weeks will need Medical Director consultation
 
Other (Current)
Must live within 30 minutes of EMS transport to hospital and have a cell phone.
Must have OB transfer of care.
Significant episodes of bleeding requires hospital admission.
+-
Placental insufficiency
24 weeks gestation; NSTs start @ 28 weeks' gestation
 
Current
Fetal size <= 10th percentile
 
Current
AFI < 5 and/or no 2x1cm pocket of fluid
 
Current
Abnormal dopplers
 
Current
If biophysical profile is < 6/8 referral to be discussed with Medical Director.
+-
Preterm labor
24-34 weeks gestation
 
Current
Cervical change by ultrasound < 2.5cm in length or > 2cm dilated
 
Current
Clients to be discharged at 34 weeks
+-
Preterm premature rupture of membranes
>= 26 + 0 weeks' gestation. *If less than 25 + 6 weeks' gestation, referral to be discussed with Medical Director on a case-by-case basis.
 
Current
Stable cephalic or frank breech presentation confirmed by ultrasound (NOTE: can be beside U/S) on both admission and discharge. Admissions greater than 7 days, the most recent U/S prior to discharge will be used to determine stability. In the event the admission and discharge presentation are different, stability of fetal presentation must be demonstrated for a minimum of 48 hours prior to discharge.
 
Current
Must have current CBC results within 12 hours of discharge AND WBC <= 20 (10Eg/L). Discharge WBC results to be documented on Discharge Summary.
 
Current
Weekly CBC must be ordered. MRHP is responsible for processing lab work. Enter orders on Antenatal Home Monitoring Order Set. ACCP will arrange through mobile lab.
 
Current
No labor symptoms, absence of meconium and no s/s of chorioamnionitis. No presenting part visible on speculum exam confirming rupture of membranes.
 
Current
On or completed antibiotic therapy
 
Current
Biophysical profile (BPP) >= 6/8 on referral. * If BPP < 6/8 referral to be discussed with Medical Director.
 
Current
Weekly Ultrasounds ordered and arranged through MRHP.
 
Current
  • If discharge under 48hours, MRHP should consult the ACCP Medical Director.
  • The risk of Cord Prolapse has been discussed with patient and ACCP is mutually agreed upon as the best option. Record discussion outcome in discharge summary. ACCP will reinforce teaching.  
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
If ACCP is unable to contact the patient upon referral received within 48-72 hours, the referral will be declined and returned back to referring physician.
If ACCP is unable to contact the patient upon referral received within 48-72 hours, the referral will be declined and returned back to referring physician.
 
HOURS OF OPERATION
Monday: 8:30 am - 4:30 pm
Tuesday: 8:30 am - 4:30 pm
Wednesday: 8:30 am - 4:30 pm
Thursday: 8:30 am - 4:30 pm
Friday: 8:30 am - 4:30 pm
Saturday: 8:30 am - 4:30 pm
Sunday: 8:30 am - 4:30 pm
Description:
Services are provided in patient homes and occasionally at clinic sites.

To book an immunization appointment only call 811 Monday to Friday 8:00 AM to 6:00 PM
   
 
ADDRESS
4715 8 Avenue SE
Calgary Alberta
T2A 3N4
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
Patients will be seen at their residence. Option for clinic visits available.
Patients will be seen at their residence. Option for clinic visits available.
 
PHONE
403-955-1210
403-944-7200
811 (immunization appointments only)
 
PARKING INSTRUCTIONS
Patients will be seen at their residence. Option for clinic visits available.
Patients will be seen at their residence. Option for clinic visits available.
 
EMAIL
VIRTUAL APPOINTMENT INFORMATION
Virtual appointments are not offered for this service
Virtual appointments are not offered for this service
 
PARKING MAP
Patients will be seen at their residence. Option for clinic visits available.
Patients will be seen at their residence. Option for clinic visits available.
 
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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