Pediatric Eating, Feeding & Swallowing - Outpatient Services   at
Alberta Children's Hospital
Connect Care Specialty: Rehabilitation Connect Care Department: CGY ACH EAT/FEED/SWALLOW
Alberta Health Services - Calgary Zone





Estimated time to routine appointment: Not Available
SERVICE DESCRIPTION
Provides assessment and management of children who have Pediatric Feeding Disorder in the context of complex medical or neurological conditions, or children who are enterally fed. Clinical and instrumental (VFSS, FEES) assessment and intervention are available.
Provides care to children with complex feeding or swallowing problems requiring specialized support. This may include feeding / swallowing issues associated with structural and motor disorders affecting the mouth, throat, airway, and digestive system and/or suspected aspiration.
Factors may include:
  • trouble coordinating swallowing with breathing
  • congestion during and / or after feeding
  • changes in colour or state during feeding
  • pervasive choking, coughing, or gagging during meals
  • recurrent chest congestions or pneumonias
  • medical instability or risk of deterioration
  • severe aversion to oral feeding
  • psycosocial factors severely impacting mealtime routines and feeding relationships
  • specialized support required to begin transition to enteral (tube) feeds or tube weaning to progress to oral feeds
Visit the PEAS (Pediatric Eating and Swallowing) website to find relevant information for families and care providers of children with an eating, feeding and swallowing disorder.
EMERGENCY REFERRAL PROCESS
This service does not have an emergency referral process. Direct patients to the nearest Emergency Department if they are experiencing a serious illness or injury. Patients with potentially life threatening conditions should immediately phone 9-1-1.  If an emergency consult is required, providers can call RAAPID NORTH (patients north of Red Deer) at 1-800-282-9911 or 780-735-0811 or RAAPID SOUTH (patients in and south of Red Deer) at 1-800-661-1700 or 403-944-4486.
This service does not have an emergency referral process. Direct patients to the nearest Emergency Department if they are experiencing a serious illness or injury. Patients with potentially life threatening conditions should immediately phone 9-1-1.  If an emergency consult is required, providers can call RAAPID NORTH (patients north of Red Deer) at 1-800-282-9911 or 780-735-0811 or RAAPID SOUTH (patients in and south of Red Deer) at 1-800-661-1700 or 403-944-4486.
URGENT REFERRAL PROCESS
Referrals will be triaged and prioritized according to urgency. Growth chart must be included with referral.
Referrals will be triaged and prioritized according to urgency. Growth chart must be included with referral.
ROUTINE REFERRAL PROCESS
A physician referral is required. Growth chart must be included with referral.

Connect Care Users, please use the ambulatory referrals to CGY ACH EAT/FEED/SWALLOW, using the [. EFSSREFERRALNEW] SmartPhrase and complete all requested fields.

Non-Connect Care Users: Complete the referral form including information requested below and send it to the service using the contact information in this profile.

Referral detail must include the following:

*Growth chart
A physician referral is required. Growth chart must be included with referral.

Connect Care Users, please use the ambulatory referrals to CGY ACH EAT/FEED/SWALLOW, using the [. EFSSREFERRALNEW] SmartPhrase and complete all requested fields.

Non-Connect Care Users: Complete the referral form including information requested below and send it to the service using the contact information in this profile.

Referral detail must include the following:

*Growth chart must be included with referral*
*Please list any other rehab providers/teams and their contact information on your referral*
*Please include any previous clinical eating/feeding/swallowing notes/documentation with your referral*

Relevant Referral Information                
Reason for referral- please specify your clinical concern:
Feeding and Nutrition Information:
Feeding Method: ¿ Oral (breast, bottle, cup, solids) ¿ Enteral (specify type):
Growth and Nutritional Concerns: **Include child’s growth chart with this referral and 3-day food record
  • Restricted food preferences resulting in nutrient deficiencies
  • Decreasing percentiles / crossing over percentile lines
Medical and Feeding Concerns:
  • Regression of feeding skills   
  • Reflux
  • Clinical assessment requested for VFSS
  • Transition to/from enteral feeds
  • Query aspiration        
  • Recurrent respiratory illness  
  • Coughing/choking
  • Gagging/emesis          
  • Wet voice      
  • Failure to progress texture
  • Oral motor difficulties
  • Oral aversion
  • Sensory/behavioral issues


Comments/Other Concerns: [Please provide a brief description of feeding concerns (e.g. coughs/gags when? How often? With what foods?)]
Does the child receive feeding supports within any other agency/clinic?
Relevant medical diagnosis:


Once the referral is accepted, the family will be contacted to schedule an appointment.


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ELIGIBILITY REQUIREMENTS
Provides assessment and management of children who have Pediatric Feeding Disorder in the context of complex medical or neurological conditions, or children who are enterally fed. This is not a physician led clinic. Primary care will remain with the referring physician.  

Pediatric Feeding Disorder (PFD) is defined as impaired oral intake that is not age-appropriate, lasting at least 2 weeks, and associated with one or more disturbance of: medical, nutritional, feeding skill, and/or psychosocial function, and is differentiated from Avoidant/Restrictive Food Intake Disorder (ARFID) and Eating Disorder.

Please note that referrals for feeding difficulties are also supported within the Calgary Zone Pediatric Community Rehabiliation program and referrals may be triaged and redirected to that team as appropriate.
Provides assessment and management of children who have Pediatric Feeding Disorder in the context of complex medical or neurological conditions, or children who are enterally fed. This is not a physician led clinic. Primary care will remain with the referring physician.  

Pediatric Feeding Disorder (PFD) is defined as impaired oral intake that is not age-appropriate, lasting at least 2 weeks, and associated with one or more disturbance of: medical, nutritional, feeding skill, and/or psychosocial function, and is differentiated from Avoidant/Restrictive Food Intake Disorder (ARFID) and Eating Disorder.

Please note that referrals for feeding difficulties are also supported within the Calgary Zone Pediatric Community Rehabiliation program and referrals may be triaged and redirected to that team as appropriate.
REFERRAL PHONE
403-955-7107
REFERRAL FAX
403-476-7756
PHONE
403-955-7107
FAX
403-476-7756
REFERRAL GUIDELINES
Urgent 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
Aspiration
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Outline observations e.g. coughing, choking, pervasive gagging, wet voice post feed etc. Outline current diet. Enteral feed information as appropriate.
| Within 1 month
Seen within 2 weeks.

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

Past medical history
| Within 1 month

Please include growth chart, details of chest status. Description of urgent issues required.
| Within 1 month
Seen within 2 weeks.

Inadequate oral intake
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Enteral feeds? Please include growth chart
| Within 1 month
Seen within 2 weeks. 

Nutritionally compromised
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

BMI, growth chart to be included
| Within 1 month
Seen within 2 weeks. 

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
At risk for aspiration
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Outline observations e.g. coughing, choking, pervasive gagging, wet voice post feed etc. Outline current diet. Enteral feed information as appropriate.
| Within 1 month
Seen within 2-4 weeks.

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

Past medical history
| Within 1 month

Outline observations. In the context of significant psychosocial factors severely impacting mealtime routines and feeding relationships, including force feeding.
| Within 1 month
Seen within 4 weeks. 

Enteral feeding
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Include type of enteral tube and feeds. Oral intake?
| Within 1 month
Seen within 4 weeks. 

Feeding problem
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Please describe in detail e.g. reflux impacting feeding, poor oral intake, swallowing concerns
| Within 1 month
Seen within 4 weeks. 

Nutritionally compromised
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Please include BMI, Growth Chart
| Within 1 month
Seen within 4 weeks. 

Psychological sign or symptom
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

In child? In carer?
| Within 1 month

Recurrent aspiration pneumonia
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Or chest infections related to swallowing disorder
| Within 1 month
Seen within 2-4 weeks. 

Restricted diet pattern
Medication List (dose, frequency, route)
| Within 1 month

Past medical history
| Within 1 month

Details of accepted vs. refused foods, include growth chart & BMI
| Within 1 month
Seen within 4 weeks.
ADDITIONAL SERVICE DETAILS
The multidisciplinary EFS team provides care to children with complex feeding or swallowing problems requiring speclialized support. This may include feeding / swallowing issues associated with structural and motor disorders affecting the mouth, throat, airway, and digestive system and/or suspected aspiration.
Factors may include:
  • trouble coordinating swallowing with breathing
  • congestion during and/or after feeding
  • changes in colour or state during feeding
  • pervasive choking, coughing, or gagging during meals
  • recurrent chest congestions or pneumonias
  • medical instability or risk of deterioration
  • severe aversion to oral feeding
  • psychosocial factors severely impacting mealtime routines and feeding relationships
  • specialized support required to begin transition to enteral (tube) feeds or tube weaning to progress to oral feeds
Visit the PEAS (Pediatric Eating and Swallowing) website to find relevant information for families and care providers of children with an eating, feeding and swallowing disorder.
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
Please alert re: need for appointment rescheduling/cancellation at least 48 hours in advance by phone at 403-955-7107. A maximum of two voice messages will be left for new or rescheduled appointments. If no response is received, file will be closed and re-referral required.
Please alert re: need for appointment rescheduling/cancellation at least 48 hours in advance by phone at 403-955-7107. A maximum of two voice messages will be left for new or rescheduled appointments. If no response is received, file will be closed and re-referral required.
DIRECTIONS
Please proceed to the Neurosciences Desk in the ambulatory wing on the main level of the Alberta Children's Hospital.

Alberta Children's Hospital is located on the corner of 24 Avenue NW and West Campus Drive NW.
Please proceed to the Neurosciences Desk in the ambulatory wing on the main level of the Alberta Children's Hospital.

Alberta Children's Hospital is located on the corner of 24 Avenue NW and West Campus Drive NW.
PARKING INSTRUCTIONS
Parking is paid at start of parking session - please refer to marked payment kiosks for detailed instructions.
Parking is paid at start of parking session - please refer to marked payment kiosks for detailed instructions.
PARKING MAP
ADDRESS
28 Oki Drive NW
Calgary Alberta
T3B 6A8
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
   
WHEELCHAIR ACCESSIBILITY
Yes

Main entrance

Lifts accessible onsite


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