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Anticoagulation Management Service   at
Aberhart Centre
Connect Care Specialty: Anticoagulation
Connect Care Department: EDM UAH AC ANTICOAGULATION CL
Estimated time to routine appointment: Within 1 week
Alberta Health Services - Edmonton Zone
SERVICE DESCRIPTION
Clinic has pharmacists to manage patients requiring anticoagulant therapy.The Anticoagulation Clinic (ACC) is staffed by pharmacists that provide initiation and ongoing management of anticoagulant therapies. The ACC manages patients at high thrombotic or bleeding risk, performing the following:
  • individualized education
  • coordination of applicable laboratory testing
  • ongoing anticoagulant dosing decisions
After 6 months of management by the ACC, all patients will be assessed for transfer of anticoaglant management to their primary care physician, with only those at high thrombotic / bleed risk or having ongoing anticoagulant control issued being kept within the ACC.
Clinic has pharmacists to manage patients requiring anticoagulant therapy.The Anticoagulation Clinic (ACC) is staffed by pharmacists that provide initiation and ongoing management of anticoagulant therapies. The ACC manages patients at high thrombotic or bleeding risk, performing the following:
  • individualized education
  • coordination of applicable laboratory testing
  • ongoing anticoagulant dosing decisions
After 6 months of management by the ACC, all patients will be assessed for transfer of anticoaglant management to their primary care physician, with only those at high thrombotic / bleed risk or having ongoing anticoagulant control issued being kept within the ACC.
ROUTINE REFERRAL PROCESS
Anticipated wait time of 3-7 days for appointment. 
Please ensure:
  • Patient has instructions for anticoagulants until next available appointment
  • All referall information is completed via Connect Care
Anticipated wait time of 3-7 days for appointment. 
Please ensure:
  • Patient has instructions for anticoagulants until next available appointment
  • All referall information is completed via Connect Care
URGENT REFERRAL PROCESS
Urgent referrals are those not requiring same day service yet need to be managed SOONER than routine
  • Physician - please call the Anticoagulation Clinic (ACC) at 780-407-8597 and speak with pharmacist, explaining the reason for urgency
  • Flag referral as "URGENT" during referral process in connect care
  • ACC may not be able to accomodate same day apointment / management
  • NOTE: there is no physician in the ACC, for medical consults refer to hematology or the VTE clinic
Urgent referrals are those not requiring same day service yet need to be managed SOONER than routine
  • Physician - please call the Anticoagulation Clinic (ACC) at 780-407-8597 and speak with pharmacist, explaining the reason for urgency
  • Flag referral as "URGENT" during referral process in connect care
  • ACC may not be able to accomodate same day apointment / management
  • NOTE: there is no physician in the ACC, for medical consults refer to hematology or the VTE clinic
EMERGENCY REFERRAL PROCESS
Please direct patients to the nearest Emergency Department or Urgent Care Facility.
  • Patients requiring immediate medical assessment or treatment / initiation of anticoagulant therapy
  • Patients taking anticoagulants with signs or symptoms of thrombosis or major bleeding.
Please direct patients to the nearest Emergency Department or Urgent Care Facility.
  • Patients requiring immediate medical assessment or treatment / initiation of anticoagulant therapy
  • Patients taking anticoagulants with signs or symptoms of thrombosis or major bleeding.
ELIGIBILITY REQUIREMENTS
Patients accepted are prioritized based on risk, with the following factors:
  • Age > 16 years
  • Prior bleeding or thrombotic complication on anticoagulant therapy.
  • Significant comorbity impacting anticoagulant control.
  • Interacting medications impacting anticoagulant control.
  • Higher thrombotic risk encompasses:
    • Mechanical mitral valves
    • Mechancial aortic valves with AF, HF, HTN, CVA/TIA/TE
    • Valvular AF or NVAF with CHADS2 >/=3
    • VTE (within 3 months), VTE with hypercoagulable states or recurrent VTE.
Patient or caregiver must have access to telephone and must demonstrate capacity to understand the condition and impllication of therapy.

The Anticoagulation Clinic (ACC) will NOT take the following:
  • Inpatients continuing on anticoagulants previously managed by family doctor that are not high risk (criteria above).
  • Patients at lower thrombotic risk.
  • If patient resides in a Zone with an ACC (e.g., Calgary Zone, Central Zone)
Patients accepted are prioritized based on risk, with the following factors:
  • Age > 16 years
  • Prior bleeding or thrombotic complication on anticoagulant therapy.
  • Significant comorbity impacting anticoagulant control.
  • Interacting medications impacting anticoagulant control.
  • Higher thrombotic risk encompasses:
    • Mechanical mitral valves
    • Mechancial aortic valves with AF, HF, HTN, CVA/TIA/TE
    • Valvular AF or NVAF with CHADS2 >/=3
    • VTE (within 3 months), VTE with hypercoagulable states or recurrent VTE.
Patient or caregiver must have access to telephone and must demonstrate capacity to understand the condition and impllication of therapy.

The Anticoagulation Clinic (ACC) will NOT take the following:
  • Inpatients continuing on anticoagulants previously managed by family doctor that are not high risk (criteria above).
  • Patients at lower thrombotic risk.
  • If patient resides in a Zone with an ACC (e.g., Calgary Zone, Central Zone)
ADDITIONAL SERVICE DETAILS
The Anticoagulation Clinic (ACC) has hours of operation Monday to Friday 9:00 am - 4:30 pm, excluding all statutory holidays and weekends.

Appointments are between 0900 - 1130 and are scheduled with patients by the ACC - appointment length is 45-90 minutes, depending on the service required.  Patients are to bring a full list of all prescription and non-prescription medications / herbals. Education will be provided, so it may be preferable to bring a significant other to the appointment.
The Anticoagulation Clinic (ACC) has hours of operation Monday to Friday 9:00 am - 4:30 pm, excluding all statutory holidays and weekends.

Appointments are between 0900 - 1130 and are scheduled with patients by the ACC - appointment length is 45-90 minutes, depending on the service required.  Patients are to bring a full list of all prescription and non-prescription medications / herbals. Education will be provided, so it may be preferable to bring a significant other to the appointment.
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 7 calendar days.
  • Communication of initial appointment outcomes to referral source will occur within 7 calendar days.
 
PHONE
780-407-8597
FAX
780-407-8907
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
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Weight
 
Current
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
+-
Pulmonary embolism
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Weight
 
Current
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
+-
Thrombosis
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Weight
 
Current
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
Atypical Thrombosis
+-
Valve
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Weight
 
Current
Labs: Baseline INR, CBC, alt, serum creatinine, eGFR
 
Within 3 months
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
First Appointment:
  • If the first appointment is missed without notification to the Anticoagulation Clinic (ACC), the ACC will endeavor to contact the patient and book another appointment.
  • If the second appointment is missed without notice, the referring provider will be notified with the patient being contacted for an attempt to book one final appointment.  
Ongoing Anticoagulant Management:
  • Repeated failure to not keep appointments (e.g. 3 missed laboratory or clinic appointmens) without notifying the ACC will result in the transfer of care from the ACC to the primary care physician.
First Appointment:
  • If the first appointment is missed without notification to the Anticoagulation Clinic (ACC), the ACC will endeavor to contact the patient and book another appointment.
  • If the second appointment is missed without notice, the referring provider will be notified with the patient being contacted for an attempt to book one final appointment.  
Ongoing Anticoagulant Management:
  • Repeated failure to not keep appointments (e.g. 3 missed laboratory or clinic appointmens) without notifying the ACC will result in the transfer of care from the ACC to the primary care physician.
 
HOURS OF OPERATION
Monday: 9:00 am - 4:00 pm
Tuesday: 9:00 am - 4:00 pm
Wednesday: 9:00 am - 4:00 pm
Thursday: 9:00 am - 4:00 pm
Friday: 9:00 am - 4:00 pm
   
 
ADDRESS
Room 8425
11402 University Avenue
Edmonton Alberta
T6G 2J3
PATIENT APPOINTMENT INSTRUCTIONS
 
DIRECTIONS
The clinic is physically located at the Aberhart Centre, University ofAlberta: Entrance is located off University Avenue east of the Cross Cancer Institute south of Kaye Edmonton Clinic South and southwest of the University of Alberta Hospital. 

Patients are seen at the Mazankowski Alberta Heart Institute - direct access from the southeast parkade or directly off 83 Avenue.

Many bus routes through area. LRT Health Sciences station nearby.
The clinic is physically located at the Aberhart Centre, University ofAlberta: Entrance is located off University Avenue east of the Cross Cancer Institute south of Kaye Edmonton Clinic South and southwest of the University of Alberta Hospital. 

Patients are seen at the Mazankowski Alberta Heart Institute - direct access from the southeast parkade or directly off 83 Avenue.

Many bus routes through area. LRT Health Sciences station nearby.
 
PHONE
780-407-8597
PATIENT RESOURCES
 
PARKING INSTRUCTIONS
Rates apply 24 hours per day, and are in effect for all public parkers, including those with provincially issued placards for persons with disabilities.  Public parking is GST exempt. Pay by Plate machines accept Canadian coins or credit card (Visa, Mastercard, American Express). Maximum 28 Canadian coins per transaction, no pennies.  Machines provide no change.    Pay on Foot machines accept Canadian coins and bills, or credit card (Visa, Mastercard, American Express). These machines will provide change. Exit gate verifiers in the Kaye Edmonton Clinic Parkade accept credit cards only, no cash. Parking Office accepts payment by cash, credit card, debit or cheque.
Rates apply 24 hours per day, and are in effect for all public parkers, including those with provincially issued placards for persons with disabilities.  Public parking is GST exempt. Pay by Plate machines accept Canadian coins or credit card (Visa, Mastercard, American Express). Maximum 28 Canadian coins per transaction, no pennies.  Machines provide no change.    Pay on Foot machines accept Canadian coins and bills, or credit card (Visa, Mastercard, American Express). These machines will provide change. Exit gate verifiers in the Kaye Edmonton Clinic Parkade accept credit cards only, no cash. Parking Office accepts payment by cash, credit card, debit or cheque.
 
EMAIL
VIRTUAL APPOINTMENT INFORMATION
 
PARKING MAP
 
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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