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Antenatal Home Monitoring Program   at
Edmonton Zone and Area
Specialty: Public Health and Preventive Medicine
Connect Care Department: EDM EEHC PH AHMP
Estimated time to routine appointment: Within 1 week
Alberta Health Services - Edmonton Zone
SERVICE DESCRIPTION
Provides in-home care from Registered Nurses for medically stable high-risk pregnant women.This service provides obstetrical nursing care for women who might otherwise be cared for in hospital.

Services include:
  • regular assessments of clients in their homes
  • fetal monitoring (non-stress tests) as ordered by the physician
  • teaching about pregnancy, birth, health concerns, and self-monitoring
  • referrals to resources as needed
  • communication with the referring health care provider
  • lab work in client's home
Provides in-home care from Registered Nurses for medically stable high-risk pregnant women.This service provides obstetrical nursing care for women who might otherwise be cared for in hospital.

Services include:
  • regular assessments of clients in their homes
  • fetal monitoring (non-stress tests) as ordered by the physician
  • teaching about pregnancy, birth, health concerns, and self-monitoring
  • referrals to resources as needed
  • communication with the referring health care provider
  • lab work in client's home
ELIGIBILITY REQUIREMENTS
For clients with pregnancy complications (see below for detailed referral guidelines) such as:
  • high blood pressure
  • preterm labour
  • preterm prelabor rupture of membranes
  • antepartum hemorrhage
  • decreased placental function
  • multi-fetal gestation
  • placenta previa
  • complex medical/social needs 
The client must:
  • Live in the program boundaries and be within 25-30 minutes of a hospital that can support the gestational age of the baby.
  • Agree to be available for home visits during program hours.
  • Be willing/able to participate in the program.
The physician must:
  • Complete BOTH referral forms as outlined in the Referral process and fax to program 
For clients with pregnancy complications (see below for detailed referral guidelines) such as:
  • high blood pressure
  • preterm labour
  • preterm prelabor rupture of membranes
  • antepartum hemorrhage
  • decreased placental function
  • multi-fetal gestation
  • placenta previa
  • complex medical/social needs 
The client must:
  • Live in the program boundaries and be within 25-30 minutes of a hospital that can support the gestational age of the baby.
  • Agree to be available for home visits during program hours.
  • Be willing/able to participate in the program.
The physician must:
  • Complete BOTH referral forms as outlined in the Referral process and fax to program 
REFERRAL SUBMISSION INSTRUCTIONS
Follow these steps before sending a referral. Incomplete referrals may be returned or declined.

  1. Read the Service Description and Eligibility Requirements to ensure your patient is appropriate for this service.
  2. Read the Referral Guidelines table below to find the reason why you are referring to this service.
  3. Click the (+) on the Referral Guidelines table below to ensure you the applicable required information and investigations to accompany the referral before submission. Review the applicable referral processes below and follow the instructions to submit the referral.
Follow these steps before sending a referral. Incomplete referrals may be returned or declined.

  1. Read the Service Description and Eligibility Requirements to ensure your patient is appropriate for this service.
  2. Read the Referral Guidelines table below to find the reason why you are referring to this service.
  3. Click the (+) on the Referral Guidelines table below to ensure you the applicable required information and investigations to accompany the referral before submission. Review the applicable referral processes below and follow the instructions to submit the referral.
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
Please complete fax both referral forms to the service using the contact information in this profile.

Please also include prenatal records.

If a patient is considered moderate to high risk, the patient's referral will be prioritized by the nurse lead to be seen no earlier than the following day based on program capacity
Please complete fax both referral forms to the service using the contact information in this profile.

Please also include prenatal records.

If a patient is considered moderate to high risk, the patient's referral will be prioritized by the nurse lead to be seen no earlier than the following day based on program capacity
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Ambulatory Referral to Public Health Antenatal, type EDM EEHC PH AHMP in the “To Department” section and complete order.
Send an Internal Referral using the Ambulatory Referral Order to Ambulatory Referral to Public Health Antenatal, type EDM EEHC PH AHMP in the “To Department” section and complete order.
ADDITIONAL SERVICE DETAILS
For clients that require more social supports in pregnancy, Antenatal Home Monitoring partners with programs such as Health for Two.
For clients that require more social supports in pregnancy, Antenatal Home Monitoring partners with programs such as Health for Two.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 1 days.
  • Wait list status update every 1 days.
  • Appointment outcome to referral source within 1 days.
 
PHONE
780-735-3046
FAX
780-342-4883
REFERRAL PHONE
780-735-3046
REFERRAL FAX
780-342-4883
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
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Polyhydramnios
 
Relevent
Unstable diabetes/dysglycemia
 
Relevant
Unable to travel to clinic (medical/social/situational)
 
Relevant
Isolated thrombocytopenia and uncertainty of hypertensive disorder in pregnancy
 
Relevant
Cholestasis of pregnancy
 
Relevent
23 weeks gestation - term
 
Current
+-
Antepartum hemorrhage
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Access to telephone (emergency services) at ALL times
 
Relevant
Bleeding has resolved for 48 hrs
 
Relevant
Inpatient for 48 hrs
 
Relevant
Less than 3 significant bleeding episodes
 
Relevant
Reside 30 minutes from nearest hospital able to support gestational age
 
Relevant
23 - 37 weeks gestation
 
Current
Absence of:
  • Active labour (<6 contractions/ hour)
  • Abdominal pain
Program medical lead consultation required for the following: 
  • More than 3 episodes of significant bleeding
+-
Hypertensive disorder
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
BP > 140/90 on 2 occasions at least 6 hours apart and/or elevated BP while on medications.
 
Relevant
ALT < 40 u/L *if mild elevation and not consistent with HELLP syndrome- physician is notified and admitted by their discretion.
 
Relevant
Platelets > 100,000/mm
 
Relevant
Serum creatinine < 100 mmol/L
 
Relevant
23 weeks gestation - term
 
Current
Absence of:
  • S/S of severe hypertension and/or HELLP syndrome (severe headache, visual disturbances, epigastric pain)
+-
Multiple pregnancy
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Intact membranes
 
Relevant
Fetal surveillance and/or secondary diagnosis of:- Preterm labour- Hypertension- Decreased placental function
 
Relevant
23 - 37 weeks gestation
 
Current
Program medical lead consultation required for the following: 

- Twin to twin transfusion
- Monochorionic Monoamniotic twins
+-
PPROM - Preterm premature rupture of membranes
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Rupture of membranes confirmed (US, nitrazine, ferning, pooling)
 
Relevant
Stable cephalic or frank breech presentation. Cervix must be 0 to 2 cm dilation if cephalic. Cervix must be closed if frank breech.
 
Relevant
Antibiotics as per protocol
 
Relevant
23 - 37 weeks gestation
 
Current
No proximity of umbilical cord at cervix on U/S.

Absence of:
  • Active and progressing labour
  • Uterine tenderness
  • Active bleeding
  • S/S of infection
+-
Placenta previa
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Complete previa or placenta <2cm from cervical os
 
Relevant
Less than 3 significant bleeding episodes
 
Relevant
Bleeding has resolved for 48 hrs
 
Relevant
Cervical length: ≥ 3cm with placenta previa≥ 2 cm with low lying
 
Relevant
Access to telephone (emergency services) at ALL times
 
Relevant
Reside 30 minutes from nearest hospital able to support gestational age
 
Relevant
23 - 37 weeks gestation
 
Current
Absence of:
  • Active labour (<6 contractions per hour)
  • Abdominal pain
Program medical lead consultation required for the following:
  • More than 3 episodes of significant bleeding
  • Short cervical length (see criteria)
  • Functional vasa previa (greater than 2-5cm from cervical os
Inpatient management should be considered for:
  • First episode of antepartum hemorrhage < 29 weeks
  • Thick placental edge
+-
Placental insufficiency
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST
 
Current
Fetal size <10th percentile
 
Relevant
Reduced rate of growth
 
Relevant
Umbilical Artery Dopplers: Normal doppler or increased resistance with forward diastolic doppler flow or intermittent absent end diastolic flow
 
Relevant
23 - 37 weeks gestation
 
Current
Program medical lead consultation required for the following:
  • BPP less than 6/8 with oligohydramnios
  • Absent end diastolic flow
No reversed umbilical artery doppler end diastolic flow
+-
Prenatal visit
Past medical history
 
Within 1 month
Prenatal assessments/visits can be performed in the home by our registered nurses for the following indications:-Clients unable to travel to office/clinic due to medical, social or situational issue.
 
Relevant
Priority given to high risk clients
 
Relevant

When staffing levels allow.
Case by case basis.
+-
Preterm labor
Past medical history
 
Within 1 month
All patients must be stable with reassuring fetal status and normal NST.
 
Current
Cervical length up to a maximum of 2.5 cm by U/S. No minimum length
 
Relevant
Maximum cervical dilation of 3 cm
 
Relevant
23 - 34 + 6 weeks gestation
 
Current
Absence of:
  • Active and progressing labour 
  • Active bleeding
  • Chorioamnionitis
Patients will be discharged at 34+6 weeks unless otherwise ordered.
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
Referring provider will be notified of frequent missed visits with the Antenatal Home Monitoring program and client may be discharged from services.
Referring provider will be notified of frequent missed visits with the Antenatal Home Monitoring program and client may be discharged from services.
 
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:
Home nursing care offered between 8:30 AM and 4:30 PM.  Please call and leave a message.  Messages will be returned between 8:30 AM and 4:30 PM.
   
 
ADDRESS

Edmonton
Alberta
T5B 0C2
PATIENT APPOINTMENT INSTRUCTIONS
  • Ensure you answer your phone when the nurse calls to arrange your appointment.
  • A family member or significant other may attend your appointment if preferred.
  • Pets must be secured in another area during your appointment.
  • No smoking in the home during the appointment.
  • Ensure you answer your phone when the nurse calls to arrange your appointment.
  • A family member or significant other may attend your appointment if preferred.
  • Pets must be secured in another area during your appointment.
  • No smoking in the home during the appointment.
 
DIRECTIONS
Clients will be seen at their residence.
Clients will be seen at their residence.
 
PHONE
780-735-3046
 
PARKING INSTRUCTIONS
Clients will be seen at their residence.
Clients will be seen at their residence.
 
EMAIL
VIRTUAL APPOINTMENT INFORMATION
No virtual appointments available at this time.
No virtual appointments available at this time.
 
PARKING MAP
Clients will be seen at their residence.
Clients will be seen at their residence.
 
WHEELCHAIR ACCESSIBILITY
N/A

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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