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This healthcare service has 1 current healthcare service locations.
Pediatric Gastroenterology (GI) Clinic Central Access and Triage   at
Calgary Zone and Area
Central Access Healthcare Service
Connect Care Specialty: Pediatric Gastroenterology
Connect Care Department: CALGARY ZONE PEDS GI CAT
Alberta Health Services - Calgary Zone
CENTRAL ACCESS SERVICES
This central access referral service provides a single point of entry for children with diseases of the gastrointestinal tract, liver and pancreas. Provides comprehensive outpatient assessment and long term management, to children with intestinal, liver, pancreas and complex nutritional disorders.
This central access referral service provides a single point of entry for children with diseases of the gastrointestinal tract, liver and pancreas. Provides comprehensive outpatient assessment and long term management, to children with intestinal, liver, pancreas and complex nutritional disorders.
ROUTINE REFERRAL PROCESS
All referrals can be submitted via:
  • Fax: Non-Connect Care users complete the referral form and send it to the service using the contact information in this profile.
  • Connect Care: Connect Care users use the Ambulatory Referral Order to CALGARY ZONE PEDS GI CAT
If non-urgent advice is required, referring physicians may call the ACH switchboard and ask to speak to the outpatient physician on call (403-955-7211).

Wait time: 6-12 months
All referrals can be submitted via:
  • Fax: Non-Connect Care users complete the referral form and send it to the service using the contact information in this profile.
  • Connect Care: Connect Care users use the Ambulatory Referral Order to CALGARY ZONE PEDS GI CAT
If non-urgent advice is required, referring physicians may call the ACH switchboard and ask to speak to the outpatient physician on call (403-955-7211).

Wait time: 6-12 months
URGENT REFERRAL PROCESS
Referring providers who require urgent consultation for their patient within 2 weeks, please call the ACH switchboard at 403-955-7211 and ask to speak to the pediatric Outpatient GI physician on call (Mon-Fri 0800-1700) AND fax a referral to 403-592-5109.
Referring providers who require urgent consultation for their patient within 2 weeks, please call the ACH switchboard at 403-955-7211 and ask to speak to the pediatric Outpatient GI physician on call (Mon-Fri 0800-1700) AND fax a referral to 403-592-5109.
EMERGENCY REFERRAL PROCESS
The following reasons for referral should be considered emergent. Patient must be refer directly to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486.
  • Esophageal button battery - is considered a life threatening emergency
  • 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
The following reasons for referral should be considered emergent. Patient must be refer directly to the Emergency Department or contact RAAPID South 1-800-661-1700 or 403-944-4486.
  • Esophageal button battery - is considered a life threatening emergency
  • 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
ELIGIBILITY REQUIREMENTS
Patients 0-18 years from southern Alberta (Red Deer, and south).

Note: Referrals for patients aged 17 - 18 may be triaged by pediatric gastroenterology, but may be re-directed to adult services.
Patients 0-18 years from southern Alberta (Red Deer, and south).

Note: Referrals for patients aged 17 - 18 may be triaged by pediatric gastroenterology, but may be re-directed to adult services.
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 21 calendar days.
  • Communication of initial appointment outcomes to referral source will occur within 30 calendar days.
ADDITIONAL SERVICE DETAILS
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. 
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. 
 
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
Abdominal pain
ALT, GGT, Bili, Lipase
 
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

Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
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
CBC
 
Within 3-6 months

Celiac screen on gluten
 
Within 3-6 months

Ferritin
 
Within 3-6 months

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

Chronic diarrhea
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

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

Iron studies
 
Within 1 month

Results of lactose free diet trial for 2-3 weeks if indicated.
 
Within 1 month

Stool O&P, culture, fecal calprotectin
 
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
Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Liver disease (chronic)/Portal Hypertension

Conjugated hyperbilirubinemia
ALT, AST, GGT
 
< 1 week

Abdominal U/S
 
< 1 week

Bili T/D
 
< 1 week

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

INR
 
< 1 week

Stool color
 
< 1 week

Constipation
Ca
 
Within 3-6 months

Celiac screen on gluten
 
Within 3-6 months

Description of stool according to Bristol Stool Chart
 
Within 3-6 months

Electrolytes, TCO2
 
Within 3-6 months

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

Pediatric consult
 
Within 3-6 months

Results of treatment according to the Enhanced Primary Care Pathway for Childhood Constipation
 
Within 1 month

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.

For guidance on the management of constipation in children, please refer to the Enhanced Primary Care Pathway for Childhood Constipation or refer to pediatrician.

Diet/texture progression difficulty
Diet/Texture progression difficulty
 
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
1. Refer to pediatrician.
2. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621 Nutrition Counselling - Pediatric

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

Dysphagia
Barium Swallow if food sticking
 
Within 1 month

Description of symptoms
 
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
Dysphagia or Odynophagia
Food bolus obstruction should be directed to Emergency Department

Failure to thrive
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

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

Medication list (including dose, frequency and route)
 
Within 1 month

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

Abdominal U/S
 
Within 3-6 months

BIL, ALB
 
Within 3-6 months

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

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

Abdominal U/S
 
Within 3-6 months

BIL, ALB
 
Within 3-6 months

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

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

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

Pediatric consult
 
< 1 month if complicated or 3-6 months if persistent for long term management
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
CBC
 
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

Hepatitis
ALT, AST, GGT
 
< 1 week

Bili, T/D
 
< 1 week

CBC
 
< 1 week

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

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

Hepatitis B and hepatitis C
Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Hepatitis B, C - serology positive

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

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

Inflammatory bowel disease
ALT, GGT, lipase
 
Within 1 month

Albumin
 
Within 1 month

C. difficile toxin
 
Within 1 month

CBC
 
Within 1 month

Description of symptoms including the following (if active send abnormal labs, if suspected send normal labs):- Diarrhea: bloody/non-bloody- Abdominal pain & characteristic- Vomiting- Weight loss (kgs/month)-Duration of symptoms- Bowel movements per day- Family history of IBD
 
Within 1 month

ESR/CRP
 
Within 1 month

Ferritin/Iron studies
 
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

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

Iron deficiency anemia
CBC
 
Within 1 month

Celiac screen on gluten
 
Within 1 month

ESR/CRP
 
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

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
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

Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
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
Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Nutrition/Nutrient Deficiency
1. Consider referral to Pediatric Nutrition Counselling (PNC) Fax- 403-476-9621

Pancreatitis
Abdominal U/S
 
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

Lipase
 
Within 1 month
Chronic/recurrent

Persistent vomiting
Abdominal U/S
 
Within 3-6 months

Barium swallow
 
Within 3-6 months

CBC
 
Within 3-6 months

Electrolytes
 
Within 3-6 months

Growth chart (or at least current height/weight)*BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Persistent vomiting/nausea
1. Pediatric gastroenterologists may refer to surgery for confirmed malrotation.
Red flag;
*bilious vomiting (emergency)

Polyposis
Family history (mutation and/or names of polyps if available)
 
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

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

Rectal bleeding age 1 year or older
Albumin
 
Within 1 month

CBC
 
Within 1 month

ESR/CRP
 
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
Age >1 year without constipation

Rectal bleeding age under 12 months
Albumin
 
Within 1 month

CBC
 
Within 1 month

ESR/CRP
 
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

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
Bili T/D
 
Within 1 month

CBC
 
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

Pediatric consult
 
Within 1 month
1. Refer to a pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.

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. 

Button battery causing toxic effect
Button Battery ingestion is a life threatening emergency. Refer to emergency. See Provincial Button Battery Protocol

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. 

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.

 

V5.0