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Complex Cancer Palliative Pain and Symptom Team   at
Arthur J.E. Child Comprehensive Cancer Centre
Specialty: Palliative Medicine
Connect Care Department: CGY ACCC PALLIATIVE PAIN SYMP
Estimated time to routine appointment: Within 1 month
Alberta Health Services - Calgary Zone
SERVICE DESCRIPTION
Provides consultation services for patients with complex cancer-related pain / symptom / palliative issues.This service operates on a consultative basis in conjunction with patients’ existing oncology and community care teams. Patients are seen by a physician or nurse practitioner. The team will follow the patient's progress until symptoms are stable, and management is then continued by patients’ existing oncology and community-based providers.
Provides consultation services for patients with complex cancer-related pain / symptom / palliative issues.This service operates on a consultative basis in conjunction with patients’ existing oncology and community care teams. Patients are seen by a physician or nurse practitioner. The team will follow the patient's progress until symptoms are stable, and management is then continued by patients’ existing oncology and community-based providers.
ELIGIBILITY REQUIREMENTS
This service is available to current Arthur J.E. Child Comprehensive Cancer Centre patients.  Patients must have symptoms caused by cancer or cancer treatment.

  • i.e. NOT chronic or non-malignant pain syndromes.  Although these are complex symptom problems, their proper management requires a coordinated multidisciplinary team approach and ability to follow regularly over the long term.  This is beyond the scope of the current Palliative/Symptom Management program at the Arthur J.E. Child Comprehensive Cancer Centre.
If patients are no longer receiving cancer treatment at ACCC and/or are already associated with Palliative Home Care, it is often preferable for palliative consultation to be arranged with the Community Palliative Consult team to allow for optimal continuity of care and clarity of caregiver roles.  In many cases, a call to the patients Home Care RN (Clinical Care Coordinator) will help clarify the best course of action. Palliative Home Care can be reached at (403) 955-6288, and can put you in contact with the RN.

Please note:  Theremay be some patients who do not fit these criteria, but would still benefit from involvement of the ACCC Complex Cancer Management team. If this is thecase, please contact one of the CCM Team members to discuss prior to referral.
This service is available to current Arthur J.E. Child Comprehensive Cancer Centre patients.  Patients must have symptoms caused by cancer or cancer treatment.

  • i.e. NOT chronic or non-malignant pain syndromes.  Although these are complex symptom problems, their proper management requires a coordinated multidisciplinary team approach and ability to follow regularly over the long term.  This is beyond the scope of the current Palliative/Symptom Management program at the Arthur J.E. Child Comprehensive Cancer Centre.
If patients are no longer receiving cancer treatment at ACCC and/or are already associated with Palliative Home Care, it is often preferable for palliative consultation to be arranged with the Community Palliative Consult team to allow for optimal continuity of care and clarity of caregiver roles.  In many cases, a call to the patients Home Care RN (Clinical Care Coordinator) will help clarify the best course of action. Palliative Home Care can be reached at (403) 955-6288, and can put you in contact with the RN.

Please note:  Theremay be some patients who do not fit these criteria, but would still benefit from involvement of the ACCC Complex Cancer Management team. If this is thecase, please contact one of the CCM Team members to discuss prior to referral.
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.
Complete the referral form and fax it to the service using the contact information in this profile.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Palliative Medicine, type CGY ACCC PALLIATIVE PAIN SYMP in the “To Department” section and complete order. 
If Urgent, follow directions above and page #10691 or call referral number listed.
Send an Internal Referral using the Ambulatory Referral Order to Palliative Medicine, type CGY ACCC PALLIATIVE PAIN SYMP in the “To Department” section and complete order. 
If Urgent, follow directions above and page #10691 or call referral number listed.
ADDITIONAL SERVICE DETAILS
Referrals are triaged/scheduled according to urgency and consultant availability.  Our triage RN works Mondays, Tuesdays, and Thursdays.
Typical wait times: 
• Pain rated as 9-10/10 = emergent (go to Emergency, same day)
• Pain rated as 7-8/10 = urgent (typically seen within 1 week)
• Pain rated as 4-6/10 = semi urgent (typically seen within 2 weeks)
• Pain rated as 1-3/10 = routine (typically seen within 4 weeks)

CCMS does not manage chronic non-malignant pain. For pain issues unrelated to cancer or cancer treatment, patients should continue to be followed by their existing community providers.
Patients are discussed at our weekly Tumour Group Rounds on Thursdays.  Oncology care providers are invited to attend.
 
Note that CCMS is a consultative service only and does not follow patients indefinitely.  If pain or symptoms worsen or new issues arise, the patient may be re-referred to the service for assessment.
A Palliative Care consultant (physician/NP) is available to aid in pain and symptom management during normal Arthur Child hours from Monday through Friday. The purpose of this service is to provide consultation in a timely manner to members of Arthur Child health care teams regarding significant symptom issues related to patients cancer or cancer treatment.
 Consultation may include:
Over the phone recommendations for intervention based on case review.
Patient assessment and recommendations to primary oncology care clinics for intervention.
Patient assessment, treatment plan development and implementation with regular phone/clinic follow up until satisfactory symptom control is achieved. Patient will then be discharged from the consultative service back to the primary care providers for ongoing management and prescriptions.
We try to remain as accessible as possible for this on-demand aspect of the consultative service, but other clinics, times of high demand, and program commitments may render us unavailable to see patients immediately.  In such cases, we will work with you by phone to find interim solutions for your patient.
Referrals are triaged/scheduled according to urgency and consultant availability.  Our triage RN works Mondays, Tuesdays, and Thursdays.
Typical wait times: 
• Pain rated as 9-10/10 = emergent (go to Emergency, same day)
• Pain rated as 7-8/10 = urgent (typically seen within 1 week)
• Pain rated as 4-6/10 = semi urgent (typically seen within 2 weeks)
• Pain rated as 1-3/10 = routine (typically seen within 4 weeks)

CCMS does not manage chronic non-malignant pain. For pain issues unrelated to cancer or cancer treatment, patients should continue to be followed by their existing community providers.
Patients are discussed at our weekly Tumour Group Rounds on Thursdays.  Oncology care providers are invited to attend.
 
Note that CCMS is a consultative service only and does not follow patients indefinitely.  If pain or symptoms worsen or new issues arise, the patient may be re-referred to the service for assessment.
A Palliative Care consultant (physician/NP) is available to aid in pain and symptom management during normal Arthur Child hours from Monday through Friday. The purpose of this service is to provide consultation in a timely manner to members of Arthur Child health care teams regarding significant symptom issues related to patients cancer or cancer treatment.
 Consultation may include:
Over the phone recommendations for intervention based on case review.
Patient assessment and recommendations to primary oncology care clinics for intervention.
Patient assessment, treatment plan development and implementation with regular phone/clinic follow up until satisfactory symptom control is achieved. Patient will then be discharged from the consultative service back to the primary care providers for ongoing management and prescriptions.
We try to remain as accessible as possible for this on-demand aspect of the consultative service, but other clinics, times of high demand, and program commitments may render us unavailable to see patients immediately.  In such cases, we will work with you by phone to find interim solutions for your patient.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 14 days.
  • Appointment outcome to referral source within 30 days.
 
PHONE
587-231-3100
FAX
403-270-9652
REFERRAL PHONE
587-231-3100
REFERRAL FAX
403-270-9652
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
+-
Neuropathic pain
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
All lab work done within previous month
 
Within 1 month
All relevant DI - reports and films
 
If available
Patients with predominantly NEUROPATHIC PAIN should also have been started on a first-line neuropathic pain medication prior to referral.
  • Neuropathic pain = pain caused by direct involvement of the nervous system (e.g. tumour invading nerves or chemotherapy-induced peripheral neuropathy)
  • First line neuropathic agent - gabapentin/pregabalin or tricyclic/SNRI antidepressant
+-
Pain control management
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
All lab work done within previous month
 
Within 1 month
All relevant DI - reports and films
 
If available
Any operative reports for primary tumour (current or previous), biopsy and definitive surgery
 
Current
Consultation notes
 
Current
Histological confirmation of malignancy
 
Current
Histopathological reports - for any surgical procedures, biopsy, or cytology
 
Current
List of symptom control medications - past & present
 
Current
Patients with predominantly NOCICEPTIVE PAIN should have tried at least one strong opioid prior to referral.
  • Nociceptive pain = pain from bone or visceral metastases
  • Strong opioids = morphine, hydromorphone, oxycodone, or fentanyl
+-
Symptom control
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
All lab work done within previous month
 
Within 1 month
All relevant DI - reports and films
 
if available
Any operative reports for primary tumour (current or previous), biopsy and definitive surgery
 
Current
Consultation notes
 
Current
Histological confirmation of malignancy
 
Current
Histopathological reports - for any surgical procedures, biopsy, or cytology
 
Current
List of symptom control medications - past & present
 
Current
Symptoms including nausea, constipation, fatigue, anorexia/cachexia, psychosocial, breathlessness, unexplained cognitive impairment.
  • poorly controlled symptoms = urgent (typically seen within 1 week)
  • moderate symptoms = semi urgent (typically seen within 2 weeks)
  • mild symptoms, end of life planning = routine (typically seen within 4 weeks)
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
Please be aware that if 3 appointments are missed without reason, we will require a new referral to be sent from the referring provider.
Please be aware that if 3 appointments are missed without reason, we will require a new referral to be sent from the referring provider.
 
HOURS OF OPERATION
Monday: 8:15 am - 4:30 pm
Tuesday: 8:15 am - 4:30 pm
Wednesday: 8:15 am - 4:30 pm
Thursday: 8:15 am - 4:30 pm
Friday: 8:15 am - 4:30 pm
   
 
ADDRESS
3395 Hospital Drive NW
Calgary Alberta
T2N 5G2
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
If approaching from the east, use the East Site Entrance off 29th Street NW.

If approaching from the west, use the Hospital Drive turn-off from 16th Avenue.
If approaching from the east, use the East Site Entrance off 29th Street NW.

If approaching from the west, use the Hospital Drive turn-off from 16th Avenue.
 
PHONE
587-231-3100
 
PARKING INSTRUCTIONS
The closest parking option is located in the underground parking lot of the Arthur Child, directly off of Hospital Drive. Paid parking is available.
The closest parking option is located in the underground parking lot of the Arthur Child, directly off of Hospital Drive. Paid parking is available.
 
EMAIL
VIRTUAL APPOINTMENT INFORMATION
 
 
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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