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Urology Centralized Access - Facilitated Access to Specialized Treatment (FAST)   at
North Zone and Area
Central Access Healthcare Service
Specialty: Urology
Estimated time to routine appointment: Not Available
Alberta Health Services - North Zone
CENTRAL ACCESS SERVICES
Referrals for Urology service in the North Zone are accepted through this Facilitated Access to Specialized Treatment (FAST) central access and intake program. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider. FAST receives the surgical referrals, reviews them for completeness and duplication, and then sends them to appropriate surgeons for triage and booking.
Referrals for Urology service in the North Zone are accepted through this Facilitated Access to Specialized Treatment (FAST) central access and intake program. Referring providers can choose a next-available surgeon with the shortest waitlist; a specific surgeon, clinic, or site; or an out-of-zone provider. FAST receives the surgical referrals, reviews them for completeness and duplication, and then sends them to appropriate surgeons for triage and booking.
ELIGIBILITY REQUIREMENTS
Review reasons for referral table below for eligibility requirements.
Review reasons for referral table below for eligibility requirements.
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
1. Complete the referral form or a referral letter stating the reason for referral.
2. Attach all mandatory information to the referral (see Provincial Adult Urology Referral Pathway for details)
3. Fax completed referral to North Zone FAST at 1-833-627-7025.

You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.

Urgent Referrals: Call RAAPID North at 1-800-282-9911.
Patient may need to be seen immediately. Patients with conditions that require same day intervention and/or diagnostics but not hospitalizations and not life threatening.

The following are considered emergent reasons and patient need to be seen immediately:
• Acute Scrotal Pain
• Testicular Torsion
• Acute Renal Colic with Fever
• Genitourinary Trauma
• Genitourinary Tract Foreign Body
Call RAAPID North at 1-800-282-9911 or send to Emergency Department via 911 as appropriate.
1. Complete the referral form or a referral letter stating the reason for referral.
2. Attach all mandatory information to the referral (see Provincial Adult Urology Referral Pathway for details)
3. Fax completed referral to North Zone FAST at 1-833-627-7025.

You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.

Urgent Referrals: Call RAAPID North at 1-800-282-9911.
Patient may need to be seen immediately. Patients with conditions that require same day intervention and/or diagnostics but not hospitalizations and not life threatening.

The following are considered emergent reasons and patient need to be seen immediately:
• Acute Scrotal Pain
• Testicular Torsion
• Acute Renal Colic with Fever
• Genitourinary Trauma
• Genitourinary Tract Foreign Body
Call RAAPID North at 1-800-282-9911 or send to Emergency Department via 911 as appropriate.
REFERRAL PROCESS - FOR CONNECT CARE USERS
An Outgoing Referral is required for this service.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in workqueue 5.

You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.

Urgent Referrals: Call RAAPID North at 1-800-282-9911.
Patient may need to be seen immediately. Patients with conditions that require same day intervention and/or diagnostics but not hospitalizations and not life threatening.

The following are considered emergent reasons and patient need to be seen immediately:
• Acute Scrotal Pain
• Testicular Torsion
• Acute Renal Colic with Fever
• Genitourinary Trauma
• Genitourinary Tract Foreign Body
Call RAAPID North at 1-800-282-9911 or send to Emergency Department via 911 as appropriate.
An Outgoing Referral is required for this service.
Change the referral class to “Outgoing Referral” on the Ambulatory Order and complete order.
Outgoing orders are not sent electronically and require processing in workqueue 5.

You can also submit referrals through:
• Alberta Netcare eReferral: Follow these instructions.

Urgent Referrals: Call RAAPID North at 1-800-282-9911.
Patient may need to be seen immediately. Patients with conditions that require same day intervention and/or diagnostics but not hospitalizations and not life threatening.

The following are considered emergent reasons and patient need to be seen immediately:
• Acute Scrotal Pain
• Testicular Torsion
• Acute Renal Colic with Fever
• Genitourinary Trauma
• Genitourinary Tract Foreign Body
Call RAAPID North at 1-800-282-9911 or send to Emergency Department via 911 as appropriate.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
 
CENTRAL ACCESS REFERRAL PHONE
1-833-553-3278 ext 1
CENTRAL ACCESS REFERRAL FAX
1-833-627-7025
REFERRAL ADVICE
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
Abnormal DRE
< 4 Weeks
PSA
 
< 3 months
Abnormal DRE (new diagnosis)
  • Send referral to North Zone FAST Team

Adrenal mass
< 4 Weeks
  • Electrolyte panel (Sodium, Chloride, Potassium and Bicarbonate)-note if using paper requisition please write “electrolyte panel”
  • Creatinine, random glucose, cortisol, 24-hour urine metanephrines
  • CT or MRI abdomen
 
< 3 months
Adrenal Mass
  • Access targets:
    • <4 weeks: <4cm size
    • <2 weeks: >4cm size (urgent case)
  • Send referral to North Zone FAST Team

Anal fistula
N/A
 
N/A
Fistula Anal Region

Angiomyolipoma
Confirm with contrast enhanced CT/MRI
 
N/A
Angiomyolipoma
  • Angiomyolipoma (<4cm) - Ask for Advice: Use eReferral eConsult
  • Angiomyolipoma (>4cm) - Send referral to North Zone FAST Team

Bladder diverticulum
Urinalysis
 
< 6 months
Process: Ask for advice: Use eReferral eConsult.

Bladder fistula
< 1 Month
CT Cystogram
 
< 3 months
Alternate name: Bladder Fistula (documented)

Process: Send referral to North Zone FAST Team

Bladder mass
< 2 Weeks
N/A
 
N/A
Process: Send referral to North Zone FAST Team

Bladder stone
< 3 Months
N/A
 
N/A
Process: Send referral to North Zone FAST Team

Dysfunctional voiding
< 6 Months
Urinalysis, urine culture
 
< 6 months

Renal bladder ultrasound (no x-ray needed)
 
< 6 months
Alternate name: Female Voiding Dysfunction

Process: Send referral to Zone FAST Team

Elevated PSA with no previous prostate cancer
< 4 Weeks
Urinalysis, urine culture (if urinalysis abnormal), prostate-specific antigen (PSA) x 2 done at least 4 weeks apart
 
< 3 months
Alternate name: Elevated PSA (no previous prostate cancer)
Process:

Elevated PSA with previous prostate cancer
< 4 Weeks
Urinalysis, urine culture (if urinalysis abnormal), prostatespecific antigen (PSA) x 2 done at least 4 weeks apart
 
< 3 months
Alternate name: Elevated PSA (previous prostate cancer)
Process:

Epididymal cyst
< 6 Months
Scrotal ultrasound, which must include measured dimensions of the cyst.
 
< 6 months
Alternate name: Epididymal Cyst

Symptomatic > 1 cm, spermatocele.

Process: Send referral to North Zone FAST Team

Erectile dysfunction
< 6 Months
AM total testosterone (to be completed within the hours of 0800-1000)
 
< 6 months
Process: Send referral to North Zone FAST Team

Other information:
  • Refer only if patient has failed 2 different PDE 5 Inhibitors x 5 consecutive doses (each) or additional trials could not be completed.
  • Confirm patient interest in penile injection therapy or surgery prior to referral.

Female urinary-genital tract fistula
< 3 Months
CT cystogram
 
< 3 months
Alternate name: Fistula - Female Urinary Genital Tract

Process: Send referral to North Zone FAST Team

Foreskin problem
< 3 Months
N/A
 
N/A
Alternate name: Foreskin Problems (includes Phimosis)

Other information: Patient must have failed a two-month trial of a steroid cream prior to referral.

Process: Send referral to North Zone FAST Team.

Gross hematuria
< 4 Weeks
  • Creatinine
  • CT Urogram - with indication of “gross hematuria, urology consult pending.”
 
N/A
Alternate name: Hematuria Gross

Process:
Other Information:
  • Do Not Delay Urology Referral for CT results
  • The referral to urology and for CT should made concurrently
  • Ultrasound and Urine CYTOLOGY is not indicated and will be performed by urology as required

Hematospermia
< 6 Months
Urinalysis, urine culture
 
< 3 months

PSA, if between age 40-75
 
< 3 months

Abdominal and pelvic ultrasound
 
< 3 months
Process: Ask for Advice: Use eReferral eConsult

Hydrocele of testis
< 6 Months
Scrotal ultrasound, which must include measured dimensions of the hydrocele
 
< 3 months
Alternate name: Hydrocele (Must be symptomatic and clinically detectable on exam)

Process: Send referral to North Zone FAST Team

Other information: Refer for Symptomatic or Clinically significant findings only.

Hydronephrosis
< 4 Weeks
Creatinine, urinalysis
 
< 3 months

Renal and bladder ultrasound - If CT, no ultrasound needed
 
< 3 months
Process:Send referral to North Zone FAST Team

Hypospadias
N/A
 
N/A
Process: Send referral to North Zone FAST Team

Kidney stone
< 2 Weeks
Electrolyte panel (Sodium, Chloride, Potassium and Bicarbonate)- note if using paper requisition please write "electrolyte panel”
 
< 30 days

Calcium, creatinine, urinalysis
 
< 30 days

Kidney Ureter Bladder (KUB) x-ray and renal colic CT or KUB x-ray and abdominal ultrasound
 
< 30 days

Must have KUB x-ray - Referrals with ultrasounds only, will not be accepted
 
N/A
Alternate name: Kidney Stone (Acute/Uteretic)

Process: Send referral to North Zone FAST Team

If there is a discrepancy between the ultrasound and KUB x-ray, please consider a CT scan

Lower urinary tract symptoms
< 6 Months
Urinalysis, Renal and bladder ultrasound
 
< 6 months

BPH: Patient must have failed a one-month trial of tamsulosin (Flomax) prior to referral.
 
N/A
Alternate name: Lower Urinary Tract Symptoms (male LUTS). Includes BPH, Urethral Strictures, Prostatitis, Male Chronic Pelvic Pain

Refer to: Clinical Pathway: Provincial Male Luts Primary Care Clinical Pathway 

Access target: < 2 weeks for urgent cases

Process: Send referral to North Zone FAST

Other information: Baseline International Prostate Symptom Score (IPSS) form, post-treatment IPSS.

Male infertility
< 3 Months
  • AM total testosterone (to be completed within the hours of 0800-1000)
  • Estradiol
  • FSH
  • LH
  • Prolactin
  • Semen analysis
 
< 6 months
Process: Send referral to Zone FAST Team

Male sexual dysfunction
< 6 Months
Referrals for low testosterone or hypogonadism require the following:
  • AM total testosterone (to be completed within the hours of 0800-1000)
 
N/A
Male Sexual Dysfunction
Includes Low Testosterone, Hypogonadism, Ejaculatory Dysfunction, Rapid Ejaculation

Process: Ask for advice: Use eReferral eConsult

Mass of penis
< 2 Weeks
CBC and INR
 
< 3 months

Abdominal/pelvis CT with contrast
 
< 3 months
Alternate name: Penile Mass (cancer concern)

Process: Send referral to North Zone FAST Team

Microscopic hematuria
< 3 Months
Creatinine, urinalysis x 2 (approx.1 month apart)
 
< 12 months

Renal and bladder ultrasound - If patient has had a CT, an ultrasound is not necessary
 
< 12 months

Hematuria Microscopic must be greater than or equal to 3 RBC/HPF on at least two urinalysis prior to referral
 
N/A
Alternate name: Hematuria Microscopic (≥3 rbc/hpf)
Process:
Urine CYTOLOGY is not indicated and will be performed by urology as required.

Neurogenic bladder
< 6 Months
Creatinine, urinalysis, urine culture
 
< 3 months

Renal and bladder ultrasound
 
< 3 months
Process: Send referral to North Zone FAST Team

Non-obstructive kidney stone
< 3 Months
Electrolytes (Sodium, Chloride, Potassium and Bicarbonate)-note if using paper requisition please write “electrolyte panel”
 
< 3 months

Calcium, creatinine, urinalysis
 
< 3 months

Kidney Ureter Bladder (KUB) x-ray and renal colic CT or KUBx-ray and abdominal ultrasound
 
< 3 months

Must have KUB x-ray - Referrals with ultrasounds only will not beaccepted
 
< 3 months
Alternate name: Kidney Stone Non-Obstructive

Process:
If there is a discrepancy between the ultrasound and KUB x-ray, please consider a CT scan.

Orchidectomy
Diagnosis of gender dysphoria as outlined in the Provincial Adult Gender Affirming Care Pathway
 
N/A
Orchidectomy (Gender Affirming)
Process:

Overactive bladder
< 6 Months
Creatinine, urinalysis, urine culture
 
< 3 months

Renal and bladder ultrasound
 
< 3 months
Alternate name: Overactive Bladder (OAB)

Process: Send referral to North Zone FAST Team

Persistent testicular pain
< 6 Months
Urinalysis, Urine culture
 
< 6 months

Scrotal ultrasound
 
< 6 months
Alternate name: Testicular Pain Chronic (non-STD)
For STD-related pain, refer to zonal STD clinic.

Process:
  • If Urgent - Call RAAPID
  • If non-urgent, Send referral to Zone FAST Team

Peyronies disease
< 6 Months
Patient to bring picture of erection to appointment (within 30 days)
 
Within 30 days

  • AM total testosterone(to be completed within the hours of 0800-1000)
  • Fasting glucose
  • Lipids panel
 
< 6 months
Process: Send referral to North Zone FAST Team

Renal cyst
< 3 Months
If mass originally identified on US: order Renal Mass Protocol CT
 
N/A

If mass originally found on Contrast Enhanced CT Abd/Pelvis: Urology to order further imaging (if required)
 
N/A
Alternate name:
Renal Cyst (Simple, Asymptomatic)Renal Cyst (Complex or symptomatic simple)
Access target: <2 weeks for urgent
Process: 
  • Refer to Clinical Pathway: Provincial Renal Mass Primary Care Pathway
  • Complex is considered a Bosniak Category IIF (with symptoms), III or IV
  • If Bosniak Category IIF with no symptoms. Follow Renal Mass Protocol CT/MRI q6-12 months for the first year and then yearly x 5 years. No consultation required.
  • Send referral to North Zone FAST Team

Renal mass
< 4 Weeks
If mass originally identified on US: order Renal Mass Protocol CT
 
N/A

If mass originally found on Contrast Enhanced CT Abd/Pelvis: Urology to order further imaging (if required)
 
N/A
Alternate name: Renal Mass (suspicious for
malignancy)

Process:

Testicular mass
< 1 Week
N/A
 
N/A
Alternate name: Testicular Mass

Process: Send referral to North Zone FAST Team

Testicular microlithiasis
< 6 Months
Scrotal ultrasound
 
< 6 months
Process: Ask for Advice: Use eReferral eConsult.

Undescended testicle
N/A
 
N/A
Alternate name: Undescended Testicle with Negative BHCQ and AFP

Process:
  • If urgent, call RAAPID.
  • If non-urgent, send referral to North Zone FAST Team.
  • If BHCG negative, use eReferral eConsult

Urachal cyst
Abdominal ultrasound
 
< 3 months
Process: Ask for Advice: Use eReferral eConsult

Urethral disorder
< 6 Months
Urinalysis, urine culture
 
< 3 months
Alternate name: Urethral Disorder (female)
Process: Send referral to North Zone FAST Team 

Urethral stricture
N/A
 
N/A
Process: Jump to “Lower Urinary Tract Symptoms (LUTS)” on this page.

Urinary incontinence
< 6 Months
Pelvic ultrasound (needs to include bladder with PVR)
 
N/A

Referral letter should include description of pelvic exam findings
 
N/A

Urinalysis, urine culture, creatinine
 
< 3 months
Process:

Urinary retention - acute
< 2 Weeks
  • Creatinine
  • Urinalysis
  • Urine culture
 
< 2 weeks
Process: Send referral to North Zone FAST Team

Urinary tract infection
< 6 Months
Evidence on urinalysis and cultures of 2 UTIs in 6 months or 3 UTIs in 12 months
 
N/A

  • Creatinine
  • Urinalysis
  • Urine culture
  • Renal and bladder ultrasound
  • Include a copy of medications used for treatment
 
< 3 months
Urinary Tract Infection (UTI Recurrent)
Definition of recurrent UTI:
  • 2 UTI’s in 6 months, or
  • 3 UTIs in 12 months
Process:

Vaginal prolapse
< 6 Months
Creatinine, urinalysis, urine culture
 
< 3 months
Vaginal Prolapse Includes Cystocele

Process:
 Send referral to North Zone FAST Team

Varicocele
< 6 Months
Scrotal ultrasound
 
< 6 months
Varicocele Must be symptomatic and clinically detectable on physical exam

Process:
Ask for advice: Use eReferral eConsult

Vasectomy
< 6 Months
N/A
 
N/A
Process: Send referral to North Zone FAST Team

Vasectomy reversal
< 6 Months
N/A
 
N/A
Process: Send referral to North Zone FAST Team


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.

 

V6.6