Primary Care
Outpatient Clinic
Primary care in Iqaluit is provided out of the Outpatient Clinic located on the 1st floor of the clinic side (“the new hospital”) of the hospital.
The Outpatient Clinic is run by regular and locum family physicians, family medicine residents and nurse practitioners.
Each Our local surgeon, our internal medicine specialist and pediatricians also run their clinics out of this area. Each of these teams have an LPN who usually sees the patient first, takes vitals and can chaperone and assist for pelvic exams, etc.
Outpatient Clinic
Clinic hours:
Monday to Friday: 9:00 – 17:00
Lunch: 12:00 – 13:00
Bookings:
Short appointments: most appointments are 20 minutes
Long appointments: full physicals, paps and procedures are booked for 40 minutes
Follow-ups: there are “MD only” booking slots at the end of the morning and at the end of the afternoon for physicians to book their own follow-ups. If these slots are not filled by the morning of the clinic, the booking staff will schedule same day appointments into these slots.
Charting: there are three charting slots to allow physicians to catch-up on paperwork. Physicians may book patients into these at their own discretion.
Operations
Viewing your schedule
Your clinic day will appear in iEHR under “Community-Wide Scheduling”. Then, please select “Scheduler Desktop” and enter your name under resource. Please use the IQ.D format in all-caps and enter the first 3 letters of your last name. Your clinic day will then appear as well as a calendar of past and upcoming clinic
Arrivals
You can tell that a patient has arrived when their Appt Status changes from “Booked” to “Attended” in the bottom right of the screen under “Appointment Information”. You can open the patient’s chart by selecting the EMR button.
Labels
All patients are given labels when they register at the front desk. Please ensure to label all laboratory specimens that you collect and properly label forms.
Patient Rosters
Most patients in our clinic do not have a regular family physician. Continuity of care is a continually improving work in progress.
Licensed Practical Nurse
A licensed practical nurse (LPN) is available to assist with procedures, chaperone, and answer questions about equipment. They are extremely helpful and a valuable resource!
Requisitions
Most requisitions and consultations documents are on Meditech under Orders, except for MRI, Genetic Screening, bone densitometry scan and other nuclear medicine scan, chronic pain clinic referral, cytology or biopsy questions, which can all be found in every room desk or in the filing cabinet in the main office near the mailboxes.
Referrals
See section on Specialist Services and other Referrals
Chart Requests
There are orange chart requisition forms that you can fill out and place in the filing bin if you need to pull a chart to interpret a result. The file will be placed on the shelves next to the mailboxes. If the matter is urgent, you can phone Health Records (extension 1406).
Follow Ups
You will be assigned a mailbox under your name
Make sure to review the chart prior to requesting a follow-up appointment for a patient. Often, the result has already been received and dealt with by another physician.
Please confirm any necessary follow up when abnormal results are received in your mailbox. This can be a challenging part of our practice but is essential for patient safety. The clinic staff and regular physicians are happy to assist you if you have questions about results and follow-up.
If you would like a patient to be recalled for review of a non-urgent test result, you can either call them to review the result yourself (as this saves precious clinic time), or book them yourself in your upcoming clinic or you can place their result in the “To be booked” mailbox with a “Book with next available MD” on a result. If the result is more urgent, you must arrange follow up yourself with support staff in the clinic or have them called to the ER.
When patients are called back to see a doctor for results, a copy of the result that they have been called in for will be on the chart and noted on the computer.
New prenatal patients should be told to book their next appointment with one of the regular OBS doctors. They can contact the OBS LPN at extension 5427. You can consider ordering the initial prenatal investigation panel (under “sets” in ambulatory orders). Please refer to OBS orientation package.
Prescriptions
For Iqaluit patients: there are 2 pharmacies in our region, the Northmart (p 975-3544, f 975-3536) and the Valupharm (p979-0655, f 979-0654). Confirm with your patient which pharmacy they use. Please indicate which pharmacy a script is to be faxed to if placing it in the “To Be Faxed” bin in clinics or ER.
For patients not from Iqaluit: please document on the prescription if the patient is staying at Boarding Home; coming to pick up their meds or would prefer us to deliver to their respective health centre. This helps the medication get to the patient in a timely manner.
Up-island patients: they may have the boarding home pick up their medications on their behalf and they can pick up their prescription at reception. They may also request to get a ride down with a driver to pick up their medication at the pharmacy themselves.
Newborns: Please document the newborn's name if you are sending down a prescription for Vitamin D. We cannot fill a prescription for a patient with no name. If they have not been named, remind the parents to call their pharmacy with their baby’s name as soon as possible.
Narcotics: there are no specific narcotic prescription pads.
Rapid Access Clinic
The Rapid Access Clinic (RAC) or Same Day appointment clinic is a fast-paced, walk-in clinic designed to reduce the patient load of the emergency room.
RAC appointments are same-day appointments lasting 15 minutes.
They should be for a single, non-emergent, simple problem (URTI Sx, Rx refill, sick note, UTI). These should not require much lab work, imaging, close follow-up, or an extensive history or physical or procedures. You will be working alongside an LPN who will select cases that are appropriate (and weed out inappropriate ones) and will bring patients in.
Narcotic prescriptions should not be renewed at the RAC.
Fracture Clinic
The QGH Fracture Clinic has been operating since January 2018. Please take the time to read through the information provided below and use this as a reference tool if you’re thinking of referring a patient to this clinic in the future.
The rules outlined below are not set in stone. If you are unsure if a patient is appropriate for referral, please feel free to ask.
When?
Every Tuesday from 09:00-17:00
Where?
QGH Outpatient Clinics
Who?
Patients: Adults and Pediatric patients with acute nonsurgical musculoskeletal injuries. See below for appropriate referral diagnoses.
How?
If you would like a patient to be seen in the Fracture Clinic, a physician must complete a referral form on Meditech. Be sure to include details such as the diagnosis, what type of splint/cast was applied, the recommendations provided to you by the orthopedic surgeon on call and your care plan.
The MDs in the Fracture Clinic do not have time during the clinic to call the on-call orthopedic surgeon. If you feel that an injury may require referral, it must be done by you, the referring physician, at the initial patient encounter.
What should be referred to Orthopedics directly from ER and not to the Fracture Clinic?
Open fractures
Fractures with neurovascular compromise
Intra-articular fractures
Salter-Harris III/IV/V type injuries
High risk areas (Femur, spine, elbow, hip, bodies of the calcaneus/talus, mid-shaft long bones)
Neuropathic joints
Pathologic fractures (Any fracture in a bone weakened by disease)
Humeral fractures
Definitive scaphoid fractures
Knee fractures or ACL tears
Fractures requiring reduction
High grade AC separations (Grade 3+)
What is an appropriate referral to the Fracture Clinic?
AC separations (Grade 1-2)
Non-operative clavicle fractures
Elbow effusions (with no fracture seen)
Undisplaced extra-articular distal radius fractures
Clinical scaphoid injury with no radiographic evidence of fracture
Undisplaced metacarpal/metatarsal fractures
Finger/toe fractures
Knee sprains (MCL and/or Meniscal)
Isolated lateral ankle injuries (undisplaced lateral malleolus or sprains)
Any fracture that you have discussed with orthopedics and they have advised non operative management
Do not refer the patients with the following conditions:
Back injuries and pain
Injuries already being followed
Chronic conditions
Joint or bone Infections