Specialist Care
The Specialist Clinic located on the 2nd floor of the clinic side (“the new hospital”) of the hospital. Visiting specialists will hold clinics from Monday to Friday. Patients are referred to see various specialists through iEHR electronic referrals.
Specialty Clinics
The Specialty Clinic is managed by an LPN who works with the specialists to triage patients to create the clinic list. If you want to discuss whether a patient will be seen in the next visiting clinic, you can contact them at ext. 5022.
Most specialists come two to four times per year. The list of specialties includes orthopedics, neurology, gynecology, rheumatology, cardiology, ENT, urology, internal medicine, respirology, allergy and dermatology.
The Specialty Clinic Calendar will let you know when the next time the specialist will be in town.
E-Consult Service
If there will be a long wait time, please consider using the e-consults service.
This is particularly helpful with dermatology to whom you can send photos and get a quick response.
Specialist will respond within 1 week which is much faster than waiting to get into the next specialty clinic.
Contact econsultsupport@lhinworks.on.ca to register.
Referrals to Southern Specialists
As you go through your duties at QGH, you will undoubtedly encounter patients who need to be seen by specialists for further evaluation and management. This quick and easy guide aims to assist you in making this as painless as possible.
Who can refer?
Any Nunavut Licensed Practitioner can refer patients to specialists. Whether a locum or a full- time MD, all one needs is to place the referral in the electronic referral system and you should be good to go. Residents may also refer, but their referrals must have their supervisor licensing number.
How to refer?
Electronic referral system: Place the order in the system and it will print out. It will find its way to the Clinics.
Paper referrals: Much as we are trying to do away with this, there are still some referrals that can only be done on paper.
A lot of things are not ordered in the system yet or may need additional paperwork prior to its processing. The following is a list of things that need extra documentation/requisitions. All these requisitions are available at the Clinic Department.
MRI (Adult) – Complete the PAU Questionnaire, specifically the mother’s maiden name and father’s first name. Also complete the Patient Pre-Screening Questionnaire.
MRI / Diagnostics Imaging at CHEO – CHEO Diagnostic Imaging Form.
Sleep Studies
Nuclear medicine – MUGAs, 3D Echocardiograms, etc. This goes to the Ottawa Heart Institute.
Stroke Clinic Referral
Pain Clinic
OCTC - Ottawa Children's Treatment Centre. For Speech, Swallowing Studies, Audiology, etc. The referral will be reviewed by our services here prior to sending to Ottawa to confirm that the services requested are not available within a reasonable time.
MFM referrals - Maternal-Fetal Medicine for high-risk obstetrical patients. In addition to the referral, pre-natal records, and all associated investigations such as lab work and imaging reports have to be included. The more info you give the better.
Genetics
Patient transport: please consider whether the patient requires a medevac or schedevac for transportation.
Schedevacs may get a little complicated. These occur when you send a patient down to Ottawa via a regular scheduled flight for an urgent assessment at the Ottawa Hospital. Medevacs are easier to arrange. You contact the hospital that is to receive the patient, confirm an accepting MD and send the patient off. The Medevac paperwork will be filled out by the Nursing Staff.
For all Urgent Referrals and Schedevacs, it may be beneficial to contact the Case management team to advise them that there is something on the go. That way, they can keep an eye out for the paperwork.
Where to refer?
You can refer to Iqaluit, Ottawa and Winnipeg.
Iqaluit: specialists from The Ottawa Hospital and CHEO come up on a regular basis to do clinics. They see Nunavut patients and if these patients need further assessment and management in Ottawa, they will forward the information themselves.
Ottawa: *Preferred referral site. Try here first.*
Consider referring to Ottawa when:
The specialist being requested is either not one that comes up for visits or will not be available for a required period of time (ex. a cardiac patient who is semi-urgent, but cardiology was just in Iqaluit a week prior).
Emergency cases: Usually when seen in the ER or from the In-Patient Care Unit or the OR.
Please note, that if you refer to Ottawa, this does not automatically mean the patient will be seen there. The referral is reviewed by the Nurse Case Managers and if deemed more appropriate for Iqaluit, it will be re-routed to the Iqaluit Specialists Clinic.
Winnipeg: usually for Psychiatric cases or if TOH and CHEO are both full.
Specific Guidelines
Private MRI Info
There is a Private MRI clinic called the Ottawa Valley MRI which can be used. However this goes through a prior approval process. In addition to the MRI Ottawa Valley Requisition being completed, the Prior Approval Form has to be completed and signed in order to request for payment approval. Approval is not guaranteed.
Bone Mineral Density
BMDs are only covered if there is a clear clinical indication for them. Routine BMDs are not covered. If the patient decides to have this done, the patient will be responsible for their own travel and accommodation. We usually recommend that if this is to happen, they can give dates of when they will be in Ottawa and the Ottawa Case Management team (OHSNI) will try and ask the clinic if the appointment date can be arranged around those times.
Mammograms
Routine Mammograms are covered in Iqaluit but medical travel to Iqaluit is not. Only mammograms for surveillance and for those with a clinical history of cancer can travel specifically for a mammogram in Iqaluit. If you want a patient from outside Iqaluit to have a screening mammogram make sure it could be done while patient is in Iqaluit for other medical/professional or personal reasons.
Resources
Here are the names of people you may wish to contact:
Interagency Case Manager (Lena Tulugak)
(867) 975-7170
Nurse Case Manager for peadiatrics and obstetrics
(867) 975-7144
Nurse Case Manager for adults and oncology
(867) 975-7173