Pediatric Gastroenterology (GI) Clinic   at
South Health Campus
Connect Care Specialty: Pediatric Gastroenterology Connect Care Department: CGY SHC PED GASTRO CL
Alberta Health Services - Calgary Zone





Estimated time to routine appointment: Within 12 months
SERVICE DESCRIPTION
Provides care for children with diseases of the gastrointestinal tract.
Provides comprehensive inpatient, outpatient and emergency services to children with intestinal, liver and complex nutritional disorders.
EMERGENCY REFERRAL PROCESS
The following reasons for referral should be considered emergent;
  • acute diarrhea with dehydration
  • acute liver failure (INR>1.5) - within 24hrs ALT, INR and description of symptoms (e.g. altered level of consciousness)
  • acute pancreatitis
  • acute significant gastrointestinal bleeding/melena
  • caustic ingestion
  • esophageal foreign body/food impaction
Esophageal button battery - consists life threatening emergency. 

For all emergencies, refer directly to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 
The following reasons for referral should be considered emergent;
  • acute diarrhea with dehydration
  • acute liver failure (INR>1.5) - within 24hrs ALT, INR and description of symptoms (e.g. altered level of consciousness)
  • acute pancreatitis
  • acute significant gastrointestinal bleeding/melena
  • caustic ingestion
  • esophageal foreign body/food impaction
Esophageal button battery - consists life threatening emergency. 

For all emergencies, refer directly to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 
URGENT REFERRAL PROCESS
For Urgent referrals, please call the ACH switchboard at 403-955-7211 and ask to speak to the pediatric GI physician on call.
For Urgent referrals, please call the ACH switchboard at 403-955-7211 and ask to speak to the pediatric GI physician on call.
ROUTINE REFERRAL PROCESS
*All referrals are managed through the ACH site, please fax routine referral to 403-592-5109.
Some patients may be seen at the South Health Campus location based on triage. *
*All referrals are managed through the ACH site, please fax routine referral to 403-592-5109.
Some patients may be seen at the South Health Campus location based on triage. *
ELIGIBILITY REQUIREMENTS
Children 0 to 18 years.
Note: Referrals for patients aged 17 - 18 will be triaged by pediatric gastroenterology, but may be re-directed to adult services.
Children 0 to 18 years.
Note: Referrals for patients aged 17 - 18 will be triaged by pediatric gastroenterology, but may be re-directed to adult services.
REFERRAL FORM
NON-CONNECT CARE USERS
Complete the attached referral form and fax it.
Referral Form

CONNECT CARE USERS 
Use the Ambulatory Referral Order in Connect Care to make a referral.



NON-CONNECT CARE USERS
Complete the attached referral form and fax it.
Referral Form

CONNECT CARE USERS 
Use the Ambulatory Referral Order in Connect Care to make a referral.



REFERRAL PHONE
403-955-7747
REFERRAL FAX
403-592-5109
PHONE
403-956-2575
FAX
403-592-5109
REFERRAL GUIDELINES
Emergent Reason for Referral
Additional Details
+-
Acute gastrointestinal hemorrhage
Acute significant gastrointestinal bleeding/melena should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

+-
Acute pancreatitis
Acute pancreatitis should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

+-
Caustic injury gastritis
Caustic ingestion should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

+-
Dehydration
Acute diarrhea with dehydration should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

+-
Foreign body
Esophageal foreign body/food impaction should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

+-
Liver failure
Acute liver failure (INR>1.5) should be referred to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486. 

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
Abdominal pain
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

ALT, GGT, Bili
| Within 3-6 months

Albumin
| Within 3-6 months

CBC, ESR/CRP
| Within 3-6 months

Celiac screen on gluten
| Within 3-6 months

Description of symptoms (if relevant)
| Within 1 month

Pediatric consult
| Within 3-6 months
Abdominal Pain (chronic or recurrent)
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.
Red flags include;
*weight loss
*diarrhea +/- blood
*vomiting
*nocturnal waking
*fever
*fatigue
*age <3 years old

Autoantibody screening for celiac disease positive
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

CBC
| Within 3-6 months

Celiac screen on gluten
| Within 3-6 months

Ferritin
| Within 3-6 months
Celiac Screen: positive finding

Chronic diarrhea
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

C. Diff toxin (age >1 year)
| Within 1 month

CBC, ESR/CRP
| Within 1 month

Celiac screen on gluten
| Within 1 month

Description of symptoms (if relevant)
| Within 1 month

Electrolytes, TCO2
| Within 1 month

Iron studies
| Within 1 month

Stool O&P, culture
| Within 1 month

Total protein/albumin
| Within 1 month
Chronic diarrhea = duration >4 weeks
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.
Red flag;
*>5% weight loss

Chronic liver disease
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month
Liver disease (chronic)/Portal Hypertension

Conjugated hyperbilirubinemia
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

ALT, AST, GGT
| < 1 week

Abdominal U/S
| < 1 week

Bili T/D
| < 1 week

INR
| < 1 week

Stool color
| < 1 week

Constipation
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Ca
| Within 3-6 months

Celiac screen on gluten
| Within 3-6 months

Description of stool
| Within 3-6 months

Electrolytes, TCO2
| Within 3-6 months

Pediatric consult
| Within 3-6 months

TSH
| Within 3-6 months

Treatment (dose, duration, results)
| Within 3-6 months
1. Refer to pediatrician.

2. Referral from pediatrician to pediatric gastroenterology must include the required information/investigations.

Diet / texture progression difficulty
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Diet/Texture progression difficulty
| Within 1 month
1. Refer to pediatrician.

2. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621 Referral Form

3. For feeding issues refer to Eating, Feeding, Swallowing Services- Fax 403-476-7756 ph 403-955-7107

Dysphagia
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Description of symptoms
| Within 1 month
Dysphagia or Odynophagia

Failure to thrive
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

CBC, ESR/CRP
| Within 1-3 months

Ca, Phos, ALT
| Within 1-3 months

Celiac screen on gluten
| Within 1-3 months

Electrolytes, BUN, Creat.
| Within 1-3 months

Pediatric and/or Nutrition Services consult
| Within 1-3 months

Total protein/albumin
| Within 1-3 months
1. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621

2. For feeding issues refer to Eating, Feeding, Swallowing Services- Fax 403-476-7756 ph 403-955-7107

Fatty liver with elevated BMI
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

AST, ALT, GGT, ALP
| Within 3-6 months

Abdominal U/S
| Within 3-6 months

BIL, ALB
| Within 3-6 months

Lipid profile
| Within 3-6 months
Fatty Liver with elevated BMI (BMI 85th percentile or greater for age)
1. Refer to pediatrician.

2. Refer to Pediatric Center for Weight and Health (PCWH) Link

3. Referral from pediatrician to pediatric gastroenterology must include required information/investigations.

Fatty liver without elevated BMI
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

AST, ALT, GGT, ALP
| Within 3-6 months

Abdominal U/S
| Within 3-6 months

BIL, ALB
| Within 3-6 months

Lipid profile
| Within 3-6 months
Fatty Liver without elevated BMI (BMI 85th percentile or less)

Feeding difficulty with suspected aspiration
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month
1. Refer to Eating, Feeding, Swallowing Services- Fax 403-476-7756 ph 403-955-7107

2. May require a prior referral to pediatrician and/or Pediatric Nutrition Counselling for a clinical assessment.

Feeding difficulty without failure to thrive
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month
1. Refer to pediatrician.
2. Consider referral to Nutrition Services if one or more food groups are missing from diet or very low food variety with suspected nutrient deficiency.
3. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621
4. Refer to Eating, Feeding, Swallowing Services- Fax 403-476-7756 ph 403-955-7107

Food allergy
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

History and type of allergy
| Within 1 month
1. Refer to pediatrician.
2. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621

Gastroesophageal reflux disease
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Pediatric consult
| Within 1 month
1. Refer to pediatrician.

2. Persistent complicated (FTT, hematemesis, respiratory symptoms) or medication-dependent GE reflux may be referred to pediatric gastroenterology for long term management.

Hematemesis
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

CBC
| Within 1 month

Hepatitis
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

ALT, AST, GGT
| < 1 week

Bili, T/D
| < 1 week

CBC
| < 1 week

INR
| < 1 week
Hepatitis: Acute (ALT >10x normal, normal INR)

Hepatitis B and hepatitis C
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month
Hepatitis B, C - serology positive

Imaging of abdomen abnormal
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Image finding (optional)
| Within 1 month
Consider contacting pediatric gastroenterology service directly to determine the optimal approach.

Inflammatory bowel disease
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

ALT, GGT, lipase
| Within 1 month

Albumin
| Within 1 month

C. difficile toxin
| Within 1 month

CBC
| Within 1 month

Description of symptoms (if active send abnormal labs, if suspected send normal labs)
| Within 1 month

ESR/CRP
| Within 1 month

Ferritin/Iron studies
| Within 1 month

Stool C&S, O&P
| Within 1 month
Active/suspected/inactive

Iron deficiency anemia
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

CBC
| Within 1 month

Celiac screen on gluten
| Within 1 month

ESR/CRP
| Within 1 month

Iron studies
| Within 1 month

Potential reason for deficiency
| Within 1 month
1. Refer to pediatrician.
2. For anemia with suspected GI cause, refer to pediatric gastroenterology.
3. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621

Liver enzymes abnormal
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

ALT, GGT, Bili T/D
| Within 1 month

Abnormal ultrasound
| Within 1 month

Albumin
| Within 1 month

CBC
| Within 1 month

CK
| Within 1 month

INR
| Within 1 month

IgG
| Within 1 month

Viral hepatitis screen (B&C)
| Within 1 month
Abnormal on 2 occasions over 3-6 months

Nutritional deficiency
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month
Nutrition/Nutrient Deficiency
1. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621

Pancreatitis
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Abdominal U/S
| Within 1 month

Lipase
| Within 1 month
Chronic/recurrent

Persistent vomiting
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Abdominal U/S
| Within 3-6 months

Barium swallow
| Within 3-6 months

CBC
| Within 3-6 months

Electrolytes
| Within 3-6 months
Persistent vomiting/nausea
1. Pediatric gastroenterologists may refer to surgery for confirmed malrotation.
Red flag;
*bilious vomiting (emergency)

Polyposis
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Family history (mutation and/or names of polyps if available)
| Within 1 month

Previous screening/colonoscopy if available
| Optional
Polyposis, family history
1. May require referral to medical genetics.

Rectal bleeding age 1 year or older
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Albumin
| Within 1 month

CBC
| Within 1 month

ESR/CRP
| Within 1 month
Age >1 year without constipation

Rectal bleeding age < 12 months
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Albumin
| Within 1 month

CBC
| Within 1 month

ESR/CRP
| Within 1 month

Pediatric consult
| Within 1 month
Age <12 months without constipation
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.

Unconjugated hyperbilirubinemia
Medication List (including dose, frequency and route)
| Within 1 month

Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
| Within 1 month

Summary of medical and treatment history
| Within 1 month

Bili T/D
| Within 1 month

CBC
| Within 1 month

Pediatric consult
| Within 1 month
1. Refer to a pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.
ADDITIONAL SERVICE DETAILS
*All referrals are managed through the ACH site, please fax routine referral to 403-592-5109. Some patients may be seen at the South Health Campus location based on triage. *
To allow for patients to get the most appropriate timely care, please review the recommendations for where to send a referral as some of the reasons for referral should be seen initially by other providers. 
 
Nutrition Services; 
*Nutrition Counselling (Dietician) Pediatric - search for clinic in www.informalberta.ca 
 
Provincial Pediatric Weight Management Services; 
*AHS Central Access Form (www.albertahealthservices.ca/2807.asp)
*toll free phone 1-877-414-2665 / toll free fax 1-866-979-3553   
 
Feeding and Swallowing Services;
*In Calgary, please contact Feeding Coordinator, phone 403-955-7464 / fax 403-955-3261
*For questions about videofluoroscopic swallow studies (VFSS), call Feeding Coordinator.  For referral to VFSS fax to 403-955-2535.

For detailed referral pathway information please click here.  











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
Two missed appointments may require a new referral.
Two missed appointments may require a new referral.
DIRECTIONS

We are located on the 7th floor of the Outpatient Wing of the South Health Campus. Enter through the main doors on the South side of the building and take the Outpatient Elevators (located to the left of the information desk) to the 7th floor.

South Health Campus site information



We are located on the 7th floor of the Outpatient Wing of the South Health Campus. Enter through the main doors on the South side of the building and take the Outpatient Elevators (located to the left of the information desk) to the 7th floor.

South Health Campus site information



ADDRESS
Pediatric Outpatient Clinic, 7th Floor
4448 Front Street SE
Calgary Alberta
T3M 1M4
HOURS OF OPERATION
Monday:
Tuesday: 8:00 am - 4:00 pm
Wednesday:
Thursday: 8:00 am - 4:00 pm
Friday:
   
WHEELCHAIR ACCESSIBILITY
Yes

This facility is wheelchair accessible.


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