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Geriatric Evaluation Management Team   at
Edmonton Community Health Hub North
Specialty: Supportive Living
Connect Care Department: EDM ECHHN SL
Estimated time to routine appointment: Within 1 month
Alberta Health Services - Edmonton Zone
SERVICE DESCRIPTION
This team provides specialized geriatric consultation services for frail seniors (over age of 65) with complex care needs who are existing clients in Continuing Care Home Type B (formerly DSL) and Home & Community Care Type 2 (formerly PSL).Clients must be medically stable but requiring further assessment and/or management due to functional and / or cognitive decline. Clients under 65 years of age will be considered for service on a case-by-case basis.

Includes assessment and managment for geriatric syndromes such as:
  • falls / immobility
  • polypharmacy (routine use of five or more medications)
  • cognitive impairment (including behaviour changes)
  • pain management
  • incontinence (bowel or bladder)
  • nutrition / weight loss or weight gain
The geriatric specialized GEM Team works in partnership with the client’s primary care physician(s), Case Manager and Contracted Service Provider site staff in assessing and supporting management of the client’s needs. Ongoing care is provided by the client’s primary provider.
This team provides specialized geriatric consultation services for frail seniors (over age of 65) with complex care needs who are existing clients in Continuing Care Home Type B (formerly DSL) and Home & Community Care Type 2 (formerly PSL).Clients must be medically stable but requiring further assessment and/or management due to functional and / or cognitive decline. Clients under 65 years of age will be considered for service on a case-by-case basis.

Includes assessment and managment for geriatric syndromes such as:
  • falls / immobility
  • polypharmacy (routine use of five or more medications)
  • cognitive impairment (including behaviour changes)
  • pain management
  • incontinence (bowel or bladder)
  • nutrition / weight loss or weight gain
The geriatric specialized GEM Team works in partnership with the client’s primary care physician(s), Case Manager and Contracted Service Provider site staff in assessing and supporting management of the client’s needs. Ongoing care is provided by the client’s primary provider.
ELIGIBILITY REQUIREMENTS
This service is only available to existing Supportive Living clients in the Edmonton Zone via referral from their Supportive Living case manager.
Frail seniors (over age of 65) with complex care needs requiring further assessment. Clients who are medically stable and experiencing acute functional and / or cognitive decline. Clients under 65 years of age will be considered for service on a case-by-case basis.
Geriatric syndromes such as:
  • Falls / immobility
  • Polypharmacy
  • Cognitive impairment (including behaviour changes)
  • Pain management
  • Incontinence (bowel or bladder)
  • Nutrition / weight loss or weight gain
This service is only available to existing Supportive Living clients in the Edmonton Zone via referral from their Supportive Living case manager.
Frail seniors (over age of 65) with complex care needs requiring further assessment. Clients who are medically stable and experiencing acute functional and / or cognitive decline. Clients under 65 years of age will be considered for service on a case-by-case basis.
Geriatric syndromes such as:
  • Falls / immobility
  • Polypharmacy
  • Cognitive impairment (including behaviour changes)
  • Pain management
  • Incontinence (bowel or bladder)
  • Nutrition / weight loss or weight gain
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
This service does not accept direct referrals.  Requests for this service are only accepted from Supportive Living Case Managers
To submit a referral to AHS Supportive Living please contact Edmonton Zone Continuing Care Access
This service does not accept direct referrals.  Requests for this service are only accepted from Supportive Living Case Managers
To submit a referral to AHS Supportive Living please contact Edmonton Zone Continuing Care Access
REFERRAL PROCESS - FOR CONNECT CARE USERS
This service does not accept direct referrals.  Requests for this service are only accepted from Supportive Living Case Managers.
Send an Internal Referral using the Ambulatory Referral Order to Supportive Living, type EDM ECHHN SL in the “To Department” section and complete order.
This service does not accept direct referrals.  Requests for this service are only accepted from Supportive Living Case Managers.
Send an Internal Referral using the Ambulatory Referral Order to Supportive Living, type EDM ECHHN SL in the “To Department” section and complete order.
ADDITIONAL SERVICE DETAILS
Requests for Service are triaged by the GEM RNs - they review the request information and gather any collateral information required.

An appointment is set up for the client’s assessment in their suite with the GEM RN and Care of the Elderly physician. Consultation notes/recommendations are given to the primary care provider and the Supportive Living Case Manager.
Requests for Service are triaged by the GEM RNs - they review the request information and gather any collateral information required.

An appointment is set up for the client’s assessment in their suite with the GEM RN and Care of the Elderly physician. Consultation notes/recommendations are given to the primary care provider and the Supportive Living Case Manager.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 3 days.
  • Wait list status update every 3 days.
  • Appointment outcome to referral source within 3 days.
 
PHONE
780-970-6916
FAX
780-669-3001
REFERRAL PHONE
780-970-6916
REFERRAL FAX
780-669-3001
REFERRAL FORM
Referral Form not required.
Referral Form not required.
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
+-
Cognitive impairment
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
+-
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
Investigation Timing
Additional Details
+-
Pain management
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
The AHS Case Manager or family member planned to be on site for clinic day/assessment would inform the GEM RN of need to reschedule for various reasons (e.g., client is sick, client is in acute care). If the client did not want to be seen after two attempts, the referral would be cancelled.
The AHS Case Manager or family member planned to be on site for clinic day/assessment would inform the GEM RN of need to reschedule for various reasons (e.g., client is sick, client is in acute care). If the client did not want to be seen after two attempts, the referral would be cancelled.
 
HOURS OF OPERATION
Monday: 8:00 am - 4:15 pm
Tuesday: 8:00 am - 4:15 pm
Wednesday: 8:00 am - 4:15 pm
Thursday: 8:00 am - 4:15 pm
Friday: 8:00 am - 4:15 pm
Description:
Closed on Statutory holidays.
   
 
ADDRESS
13211 Fort Road NW
Edmonton Alberta
T5A 1C3
PATIENT APPOINTMENT INSTRUCTIONS
  • Please have your Alberta health care card and a piece of government issued photo ID with you.
  • The GEM RN and physician will visit you in your suite at the scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
  •  
  • Please have your Alberta health care card and a piece of government issued photo ID with you.
  • The GEM RN and physician will visit you in your suite at the scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
  •  
 
DIRECTIONS
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
 
PHONE
780-970-6916
 
PARKING INSTRUCTIONS
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
  • Bring your Alberta health care card and a piece of government issued photo ID.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • You may bring a family member or significant other during your consultation.
  • Please make sure to have someone with you if you are unable to communicate in English.
 
EMAIL
EDM.FSL-BusinessInbox@albertahealthservices.ca
VIRTUAL APPOINTMENT INFORMATION
N/A
N/A
 
PARKING MAP
There is currently no parking map available.
There is currently no parking map available.
 
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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