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Neurosurgery Spine Triage and Assessment Clinic   at
Foothills Medical Centre
Specialty: Neurosurgery
Connect Care Department: CGY FMC SPINE TRIAGE CL
Estimated time to routine appointment: 12 months
Alberta Health Services - Calgary Zone
SERVICE DESCRIPTION
Services are offered to people who have been referred, by their doctor, to see a neurosurgeon for possible spine surgery. The neurosurgery team would then assess and decide if treatment is needed.ELECTIVE ROUTINE OUTPATIENT SPINE REFERRAL ONLY.
  • STAC (Spine Triage and Assessment Clinic) reviews and triages Elective Routine Outpatient Spine Referrals for possible surgical consultation from physicians and health care providers within Southern Alberta.
  • STAC does not manage spine-related problems, provide chronic pain services or pain management care, or prescribe medications.
  • STAC aims to provide early surgical input into the care pathway for the referring physician and patient, facilitating timely access to appropriate care by the appropriate provider.
Services are offered to people who have been referred, by their doctor, to see a neurosurgeon for possible spine surgery. The neurosurgery team would then assess and decide if treatment is needed.ELECTIVE ROUTINE OUTPATIENT SPINE REFERRAL ONLY.
  • STAC (Spine Triage and Assessment Clinic) reviews and triages Elective Routine Outpatient Spine Referrals for possible surgical consultation from physicians and health care providers within Southern Alberta.
  • STAC does not manage spine-related problems, provide chronic pain services or pain management care, or prescribe medications.
  • STAC aims to provide early surgical input into the care pathway for the referring physician and patient, facilitating timely access to appropriate care by the appropriate provider.
ELIGIBILITY REQUIREMENTS
STAC does not accept the following referrals.
  • Workers Compensation Referrals:
    • Existing mechanisms exist through case managers for referral through WCB Visiting specialist clinics.
  • Second Opinion Referrals or Medical Legal Opinions:
    • Due to significant waitlists for initial consultations (First Opinions), STAC cannot accommodate second opinions.
    • Medical legal opinions should be referred for Independent Medical Legal evaluations.
  • Out of Province and Out of region Patients:
    • STAC provides services to Residents of Southern Alberta.
  • Incomplete Referrals:
    • Incomplete referrals do not meet Referral Consultation Standards as defined by the CPSA. These referrals typically lack sufficient information for reasonable triage due to the absence of Pertinent Clinical Information or Appropriate Diagnostic Imaging.
  • Patients under the care of a Spine Surgeon or another Spine Clinic:
    • STAC can not provide assessments or follow-up services for patients who have had recent spinal surgery in Alberta or elsewhere, patients who have already been referred to a spine surgeon, or patients who have been referred to or are already under treatment by another spine clinic that provides similar triage and assessment services.

REFERRAL GUIDELINES:
Many referrals to the Neurosurgery Spine Triage and Assessment Clinic do not meet Referral Consultation Standards as per CPSA. Incomplete and poor-quality referrals cause delays in patient care and can result in harm. To improve patient care, referrals to the Neurosurgery Spine Triage and Assessment Clinic MUST include the following information.

Required Information for Referrals:
  1. Referring to the physician's demographic and contact information.
  2. Patient Demographic and contact information.
  3. Pertinent clinical information supporting the reason for referral. See below.
  4. Appropriate Diagnostic Imaging. See below.

Pertinent Clinical Information:
Pertinent clinical information is critical to appropriately triage the referral and arrange for timely assessment if indicated.
Clinical Information for a Spine Surgical Consultation includes ALL the following:
  • Axial Symptoms in the involved spinal region
    • Such as Cervical, Thoracic or Lumbar spine pain
  • Specific radiating or referred symptoms in arms or legs.
    • Such as weakness, pain, numbness, or tingling
    • Bowel and Bladder Symptoms
  • Date of onset of symptoms, Severity, and Progression of Neurological Symptoms.
  • The presence of "Red flags" and other significant medical conditions.
  • Findings of the Neurological Examination
    • The referring healthcare provider is expected to perform and communicate the findings of an essential neurological examination on a referred patient.
  • Previous spinal treatments include:
    • Spine surgeries, Injections, Physiotherapy and Chiropractic treatments.
 
Appropriate Diagnostic imaging:
Patients referred to STAC must have had an MRI of the symptomatic region at the time of referral. The MRI should not be older than one year.
MRI is the preferred imaging modality for patients presenting with neurological symptoms.If an MRI is contraindicated, a CT scan may be sufficient.
STAC does not accept the following referrals.
  • Workers Compensation Referrals:
    • Existing mechanisms exist through case managers for referral through WCB Visiting specialist clinics.
  • Second Opinion Referrals or Medical Legal Opinions:
    • Due to significant waitlists for initial consultations (First Opinions), STAC cannot accommodate second opinions.
    • Medical legal opinions should be referred for Independent Medical Legal evaluations.
  • Out of Province and Out of region Patients:
    • STAC provides services to Residents of Southern Alberta.
  • Incomplete Referrals:
    • Incomplete referrals do not meet Referral Consultation Standards as defined by the CPSA. These referrals typically lack sufficient information for reasonable triage due to the absence of Pertinent Clinical Information or Appropriate Diagnostic Imaging.
  • Patients under the care of a Spine Surgeon or another Spine Clinic:
    • STAC can not provide assessments or follow-up services for patients who have had recent spinal surgery in Alberta or elsewhere, patients who have already been referred to a spine surgeon, or patients who have been referred to or are already under treatment by another spine clinic that provides similar triage and assessment services.

REFERRAL GUIDELINES:
Many referrals to the Neurosurgery Spine Triage and Assessment Clinic do not meet Referral Consultation Standards as per CPSA. Incomplete and poor-quality referrals cause delays in patient care and can result in harm. To improve patient care, referrals to the Neurosurgery Spine Triage and Assessment Clinic MUST include the following information.

Required Information for Referrals:
  1. Referring to the physician's demographic and contact information.
  2. Patient Demographic and contact information.
  3. Pertinent clinical information supporting the reason for referral. See below.
  4. Appropriate Diagnostic Imaging. See below.

Pertinent Clinical Information:
Pertinent clinical information is critical to appropriately triage the referral and arrange for timely assessment if indicated.
Clinical Information for a Spine Surgical Consultation includes ALL the following:
  • Axial Symptoms in the involved spinal region
    • Such as Cervical, Thoracic or Lumbar spine pain
  • Specific radiating or referred symptoms in arms or legs.
    • Such as weakness, pain, numbness, or tingling
    • Bowel and Bladder Symptoms
  • Date of onset of symptoms, Severity, and Progression of Neurological Symptoms.
  • The presence of "Red flags" and other significant medical conditions.
  • Findings of the Neurological Examination
    • The referring healthcare provider is expected to perform and communicate the findings of an essential neurological examination on a referred patient.
  • Previous spinal treatments include:
    • Spine surgeries, Injections, Physiotherapy and Chiropractic treatments.
 
Appropriate Diagnostic imaging:
Patients referred to STAC must have had an MRI of the symptomatic region at the time of referral. The MRI should not be older than one year.
MRI is the preferred imaging modality for patients presenting with neurological symptoms.If an MRI is contraindicated, a CT scan may be sufficient.
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
Complete the referral form and fax it to the service using the contact information in this profile.

The Spine Triage Assessment Clinic does not accept Urgent or Emergent rereferrals. If it is an emergency please call 9-1-1 or head to the nearest emergency department.
Complete the referral form and fax it to the service using the contact information in this profile.

The Spine Triage Assessment Clinic does not accept Urgent or Emergent rereferrals. If it is an emergency please call 9-1-1 or head to the nearest emergency department.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Neurosurgery, enter CGY FMC SPINE TRIAGE CL in the “To Department” section and complete order.
Send an Internal Referral using the Ambulatory Referral Order to Neurosurgery, enter CGY FMC SPINE TRIAGE CL in the “To Department” section and complete order.
ADDITIONAL SERVICE DETAILS

Triage Process:

  • Referrals are screened for completeness, reviewed by spine physicians, and then triaged based on the referring physician providing the required Pertinent Clinical Information and Appropriate Diagnostic Imaging.
  • In-person spine assessments are scheduled for patients where the Pertinent Clinical Information and Diagnostic Imaging show that a Neurosurgical Spine Assessment is clinically indicated.
  • Advice and nonsurgical treatment recommendations may be provided to the referring healthcare provider when it is determined that an in-person Neurosurgical Spine Assessment is not clinically indicated.

Assessment Process:
The in-person Neurosurgical Spine Assessment may result in the following outcomes:

  • If surgical pathology and indications for surgery are identified, the patient may see a neurosurgeon immediately or be scheduled later, depending on surgeon availability.
  • If surgery is not recommended, patient-specific advice and treatment recommendations will be discussed with the patient and provided to the referring healthcare provider via a consultation report.

Triage Process:

  • Referrals are screened for completeness, reviewed by spine physicians, and then triaged based on the referring physician providing the required Pertinent Clinical Information and Appropriate Diagnostic Imaging.
  • In-person spine assessments are scheduled for patients where the Pertinent Clinical Information and Diagnostic Imaging show that a Neurosurgical Spine Assessment is clinically indicated.
  • Advice and nonsurgical treatment recommendations may be provided to the referring healthcare provider when it is determined that an in-person Neurosurgical Spine Assessment is not clinically indicated.

Assessment Process:
The in-person Neurosurgical Spine Assessment may result in the following outcomes:

  • If surgical pathology and indications for surgery are identified, the patient may see a neurosurgeon immediately or be scheduled later, depending on surgeon availability.
  • If surgery is not recommended, patient-specific advice and treatment recommendations will be discussed with the patient and provided to the referring healthcare provider via a consultation report.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 2 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 14 days.
  • Wait list status update every 90 days.
  • Appointment outcome to referral source within 30 days.
 
PHONE
403-944-1854 (Press 7 for Spine Triage Clinic)
FAX
403-283-2270
REFERRAL PHONE
403-944-4220
REFERRAL FAX
403-283-2270
REFERRAL FORM
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
+-
Back pain
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
Neck/back pain in isolation IS NOT an indication for referral for consultation to a spine surgeon nor is it an indication for advanced diagnostic imaging, such as a MRI. 
Please follow TOP established guidelines for management of neck/back pain (www.topalbertadoctors.org).
Patients with neck/back pain without red flags or neurological symptoms are considered to be non-surgical with the exception of patients with spondylolisthesis. 

+-
Bladder dysfunction
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
Bladder or bowel dysfunction in association with: neck/back pain, pain or neurological symptoms in arms or legs, weakness in arms or legs, and/or neurogenic claudication.
+-
Bowel dysfunction
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
Bladder or bowel dysfunction in association with: neck/back pain, pain or neurological symptoms in arms or legs, weakness in arms or legs, and/or neurogenic claudication.
+-
Neck pain
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
Neck/back pain in isolation IS NOT an indication for referral for consultation to a spine surgeon nor is it an indication for advanced diagnostic imaging, such as a MRI. 
Please follow TOP established guidelines for management of neck/back pain (www.topalbertadoctors.org).
Patients with neck/back pain without red flags or neurological symptoms are considered to be non-surgical with the exception of patients with spondylolisthesis. 
+-
Neurogenic claudication
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
+-
Neurological symptom
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
+-
Pain in left arm
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
+-
Pain in leg
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
+-
Pain in right arm
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
+-
Spine
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
Any pathology that indicates: spinal degenerative disease, spinal fracture/instability, spinal infection, spinal tumor/cyst/syrinx, and/or spinal deformity.
+-
Weakness
A description of clinical problem to include the following: symptom (pain, weakness), location of symptom (low back pain, neck pain, arm pain, leg pain), duration of symptoms (days, weeks, months), details of neurological examination (dermatomal pain distribution, focal myotomal weakness).
 
Within 6 months
Co-morbid conditions
 
Within 6 months
Magnetic resonance imaging
 
Within 6 months
in arms and/or legs
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
STAC will attempts to contact new patients twice before considering cancellation of the referral. Please ensure that the contact information provided for the patients is correct.
 
STAC will cancel the referral after a patient has been a no-show for one appointment. Please note that we require a minimum of 24 hours notice for a cancellation. If we receive less than 24 hours these cancellations are classified as no-shows.
 
Phone contact information is provided to the patient during the new referral appointment booking.
STAC will attempts to contact new patients twice before considering cancellation of the referral. Please ensure that the contact information provided for the patients is correct.
 
STAC will cancel the referral after a patient has been a no-show for one appointment. Please note that we require a minimum of 24 hours notice for a cancellation. If we receive less than 24 hours these cancellations are classified as no-shows.
 
Phone contact information is provided to the patient during the new referral appointment booking.
 
HOURS OF OPERATION
Monday: 8:00 am - 4:00 pm
Tuesday: 8:00 am - 4:00 pm
Wednesday: 8:00 am - 4:00 pm
Thursday: 8:00 am - 4:00 pm
Friday: 8:00 am - 4:00 pm
Description:
Closed on weekends and statutory holidays.
   
 
ADDRESS
12th Floor, Main Building
1403 29 Street NW
Calgary Alberta
T2N 2T9
PATIENT APPOINTMENT 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
 
DIRECTIONS
Clinic is located in the Main Building, on the 12th floor. Please take main elevators to the 11th floor. Once on the 11th floor transfer to the 12th floor elevator. 

Foothills Medical Centre is located at the intersection of 16 Avenue NW and 29 Street NW.

Transit:
Public transportation is available to this facility.
Clinic is located in the Main Building, on the 12th floor. Please take main elevators to the 11th floor. Once on the 11th floor transfer to the 12th floor elevator. 

Foothills Medical Centre is located at the intersection of 16 Avenue NW and 29 Street NW.

Transit:
Public transportation is available to this facility.
 
PHONE
403-944-1854 (Press 7 for Spine Triage Clinic)
 
PARKING INSTRUCTIONS
Central Parking is now open to patients, families and visitors. Public parking is available on the Skyline (second level at grade) and Mountain levels (third level)
Most public parking at Foothills Medical Centre will be in the new Central Parking, but there are two other public parking lots for your convenience: West Parking (Lot 10) and North Parking (Lot 6).
Central Parking is now open to patients, families and visitors. Public parking is available on the Skyline (second level at grade) and Mountain levels (third level)
Most public parking at Foothills Medical Centre will be in the new Central Parking, but there are two other public parking lots for your convenience: West Parking (Lot 10) and North Parking (Lot 6).
 
EMAIL
WEBSITE
https://www.ucalgary.ca/dcns/
VIRTUAL APPOINTMENT INFORMATION
Virtual appointments are not available.
Virtual appointments are not 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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