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Emergency Information 
Otolaryngology Centralized Access - Facilitated Access to Specialized Treatment (FAST)   at
Edmonton Zone and Area
Central Access Healthcare Service
Specialty: Otolaryngology
Connect Care Department: EDMONTON ZONE ENT CAT
Estimated time to routine appointment: Not Available
Alberta Health Services - Edmonton Zone
CENTRAL ACCESS SERVICES
Referrals for Otolaryngology in the Edmonton Zone are accepted through the Facilitated Access to Specialized Treatment (FAST) centralized access program. The program improves patient access to specialty care by centralizing referral intake, ensuring referrals are complete, and distributing referrals to specialists. 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 Otolaryngology in the Edmonton Zone are accepted through the Facilitated Access to Specialized Treatment (FAST) centralized access program. The program improves patient access to specialty care by centralizing referral intake, ensuring referrals are complete, and distributing referrals to specialists. 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.
ROUTINE REFERRAL PROCESS
Submit referral by fax:
1. Complete the referral form or a referral letter following the QuRE checklist.
2. Include mandatory and extra information listed in the Provincial Adult Otolaryngology Referral Pathway.
3. Fax completed referral to Edmonton Zone FAST at 780-644-1790.
OR
Submit referral via Alberta Netcare eReferral – see Quick Reference Guide for details.
OR
Send an Internal Referral using the Ambulatory Referral Order to Otolaryngology, type EDMONTON ZONE ENT CAT in the “To Department” section and complete order.
Submit referral by fax:
1. Complete the referral form or a referral letter following the QuRE checklist.
2. Include mandatory and extra information listed in the Provincial Adult Otolaryngology Referral Pathway.
3. Fax completed referral to Edmonton Zone FAST at 780-644-1790.
OR
Submit referral via Alberta Netcare eReferral – see Quick Reference Guide for details.
OR
Send an Internal Referral using the Ambulatory Referral Order to Otolaryngology, type EDMONTON ZONE ENT CAT in the “To Department” section and complete order.
URGENT REFERRAL PROCESS
Patient may need to be seen immediately. Patients with conditions that require same day intervention and/or diagnostics but not hospitalization; not life threatening.
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 hospitalization; not life threatening.
Call RAAPID North at 1-800-282-9911.
EMERGENCY REFERRAL PROCESS
Patient needs to be seen immediately.
Call RAAPID North at 1-800-282-9911 or send to Emergency Department via 911 as appropriate.
Patient needs to be seen immediately.
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.
ADDITIONAL SERVICE DETAILS
Learn more about FAST at ahs.ca/FAST
Learn more about FAST at ahs.ca/FAST
 
CENTRAL ACCESS REFERRAL PHONE
1-833-553-3278 ext 2
CENTRAL ACCESS REFERRAL FAX
780-644-1790
REFERRAL FORMS
PATHWAYS
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
+-
Change in voice
Smoking history
 
N/A
Change in Voice
• Persistent dysphonia >4 weeks
  • Send referral to Edmonton Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
  • If available:
    • Swallowing difficulties
    • Speech Language Pathology documentation
+-
Chronic airway obstruction
N/A
 
N/A
Chronic Airway Obstruction
• i.e. inspiratory stridor
Send referral to Edmonton Zone FAST Team
If available:
  • Exercise tolerance
  • Pulmonary function test
+-
Chronic tonsillitis
N/A
 
N/A
Chronic Tonsillitis
• >12 weeks
• i.e. symptomatic tonsil stones,
halitosis, chronic sore throat

Send referral to Edmonton Zone FAST Team.
+-
Disorder of eyelid
N/A
 
N/A
Facial Nerve Paralysis
Chronic Facial Palsy >10 days
  • Send referral to Edmonton Zone FAST Team
  • Initial consultations are insured. Procedures may or may not be insured
+-
Disorder of salivary gland
N/A
 
N/A
Disorder of The Salivary Gland
i.e. stones, inflammation
  • Send referral to Edmonton Zone FAST Team
  • If available: ultrasound
+-
Drainage from external ear canal
Audiogram* (tinnitus and earfullness/pressure only)
 
N/A
Include the following information in the referral letter: - Otoscopy (normal/abnormal) - Previous ear procedures/surgery (right/left and details) - Hearing loss - History of ear infection - Vertigo - Ear Pain
 
N/A
Drainage From External Ear Canal
>3 months or unresponsive to treatment
Send referral to Edmonton Zone FAST Team.

If available Audiogram (discharge from the ear)
+-
Dysphagia
N/A
 
N/A
Send referral to Edmonton Zone FAST Team (for otolaryngology or general surgery.
If available:
  • Include description of disease progression
  • Imaging results if available
  • Allied health reports if available (i.e. clinical dysphagia assessments)
+-
Ear deformity
N/A
 
N/A
Ear Deformity
  • Send referral to Edmonton Zone FAST Team.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Ear pain
Audiogram
 
N/A
Include the following information in the referral letter:- Tinnitus (right/left/none) |Draining ear (right/left/none) |Ear pain (right/left/none) (describe characteristics) |Otoscopy (normal/abnormal) |Previous ear procedures/surgery (right/left and details) |Previous history of head trauma or concussion | History of Temporomandibular joint disorder (ear pain only)
 
N/A
Ear Pain
Otalgia persistent >4 weeks or progressive or severe
Send referral to Edmonton Zone FAST Team
+-
Ear pressure sensation
Audiogram (tinnitus and earfullness/pressure only)
 
N/A
Include the following information in the referral letter: - Otoscopy (normal/abnormal) - Previous ear procedures/surgery (right/left and details) - Hearing loss - History of ear infection - Vertigo - Ear Pain
 
N/A
Ear Pressure Sensation
Includes ear fullness, eustachian tube dysfunction
Send referral to edmonton Zone FAST Team

I available: Audiogram (discharge from the ear)
+-
Epistaxis
N/A
 
N/A
Epistaxis
• failed conservative treatment

Send referral to Edmonton Zone FAST Team
+-
Facial deformity
N/A
 
N/A
Facial Deformity
• Includes: facial injury and facial scar
  • Send referral to Edmonton Zone FAST Team
  • Facial bone fractures: refer to plastic surgery or oral and maxillofacial surgery referral pathways.
  • Initial consultations are insured. Procedures may or may not be insured.
  • If available: Clinical photograph
+-
Facial nerve paralysis
N/A
 
N/A
Facial Nerve Paralysis
  • Acute <10 days
    • Call RAAPID or request non-urgent phone advice
    • Any suspicion of stroke, send to Emergency Department via 911.
  • Chronic Facial Palsy >10 days
    • Send referral to Edmonton Zone FAST Team
    • Initial consultations are insured. Procedures may or may not be insured. Please indicate if the patient is unable to protect their eye to assist with clinical triage.

+-
Foreign body in ear
N/A
 
N/A
Call RAAPID or request non-urgent phone advice:
+-
Fracture of nasal bones
N/A
 
N/A
Fracture of Nasal Bone

• ≤7 days-URGENT REFERRAL: Call Surgeon on Call through RAAPID.
• >7 days: See Nasal Deformity Reason for Referral
+-
Globus sensation
N/A
 
N/A
Globus Sensation
  • Send referral to Zone FAST Team.
  • If available: Include the following information if relevant:
    • Dysphagia
    • Painful Swallowing
    • History of reflux
    • Reflux symptoms
    • Voice changes
    • Investigations done (i.e. Barium swallow, modified barium swallow (Videofluoroscopic swallow study), CT Neck, Ultrasound neck)
+-
Hearing loss
Audiogram
 
N/A
Include the following information in the referral letter:- Tinnitus (right/left/none) |Draining ear (right/left/none) |Ear pain (right/left/none) (describe characteristics) |Otoscopy (normal/abnormal) |Previous ear procedures/surgery (right/left and details) |Previous history of head trauma or concussion | History of Temporomandibular joint disorder (ear pain only)
 
N/A
Hearing Loss - not sudden
  • Send referral to Edmonton Zone FAST Team
  • Note: Sudden hearing loss should be treated within 14 days of onset. Order urgent audiogram to facilitate corticosteroid treatment within 14 days of onset.
    Call RAAPID or request non-urgent phone advice:
+-
Lesion of ear canal
N/A
 
N/A
Send referral to Edmonton Zone FAST Team
+-
Lesion of mouth and/or pharynx
N/A
 
N/A
Lesion of Mouth and/or Pharynx
• i.e. mucocele, leukoplakia, tonsil lesion, tongue lesion, ulcer
  • Send referral to Edmonton Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway
  • If available: Significant weight loss due to pain with eating and swallowing
+-
Mass of soft tissue
N/A
 
N/A
Mass of Soft Tissue
• head and neck mass or lesion
• i.e. cyst, lipoma
  • Send referral to Edmonton Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
  • If available: If neck mass, consider ultrasound
+-
Middle ear effusion
Audiogram
 
N/A
Include the following information in the referral letter:- Tinnitus (right/left/none) |Draining ear (right/left/none) |Ear pain (right/left/none) (describe characteristics) |Otoscopy (normal/abnormal) |Previous ear procedures/surgery (right/left and details) |Previous history of head trauma or concussion | History of Temporomandibular joint disorder (ear pain only)
 
N/A
Middle Ear Effusion
Persistent >3 months
Send referral to Edmonton Zone FAST Team
+-
Nasal deformity
N/A
 
N/A
Nasal Deformity
• Includes: reconstruction, septoplasty and rhinoplasty
  • Send referral to Edmonton Zone FAST Team.
  • Initial consultations are insured. Procedures may or may not be insured.
+-
Nasal mass
N/A
 
N/A
Nasal Mass

Send referral to Edmonton Zone FAST Team
Note: If cancer is suspected, go to the Head and Neck Cancer category of this referral pathway
Extra information if available: Provincial Head & Neck Cancer Diagnosis & Referral Pathway
+-
Nasal obstruction
N/A
 
N/A
Nasal Obstruction
• i.e. deviated nasal septum, nasal polyps, unilateral nasal obstruction
  • Send referral to Edmonton Zone FAST Team.
  • If available: History, physical exam findings and treatments attempted.
+-
Obstructive sleep apnea
History of CPAP
 
N/A
Sleep Study showing moderate to severefindings
 
N/A
Obstructive Sleep Apnea
• Moderate to Severe OSA with failed CPAP treatment warranting surgical consideration

Send referral to Edmonton Zone FAST Team.
+-
Otolaryngology surgery consultation
N/A
 
N/A
Consult For Otolaryngology
Send referral to Edmonton Zone FAST Team.
+-
Recurrent acute otitis media
Audiogram
 
N/A
Include the following information in the referral letter:- Tinnitus (right/left/none) |Draining ear (right/left/none) |Ear pain (right/left/none) (describe characteristics) |Otoscopy (normal/abnormal) |Previous ear procedures/surgery (right/left and details) |Previous history of head trauma or concussion | History of Temporomandibular joint disorder (ear pain only)
 
N/A
Acute Otitis Media
Recurrent >3 episodes in 6 months
Send referral to Edmonton Zone FAST Team
+-
Recurrent acute tonsillitis
Throat swab history
 
N/A
Recurrent Acute Tonsillitis
  • Send referral to Edmonton Zone FAST Team
  • If available:
    • Relevant hospitalization
    • Treatment history
+-
Rhinitis
Failed nasalcorticosteroid trial (4-6weeks)
 
N/A
Rhinitis
• failed conservative treatment, i.e.nasal discharge/post-nasal drip/nasal stuffiness
+-
Salivary gland mass
N/A
 
N/A
Salivary Gland Mass
  • Send referral to Edmonton Zone FAST Team.
  • Note: If suspect cancer, go to the Head and Neck Cancer category of the pathway.
  • If available: Ultrasound
+-
Sinusitis
CT sinus ordered
 
N/A
Sinusitis
• Rhinosinusitis
  • Refer to the CLINICAL PATHWAY: RHINOSINUSITIS to help guide the care of your patient prior to referral.
  • If symptoms persist after completing the Rhinosinusitis clinical pathway, send referral to Zone FAST Team.
  • If available:
    • Chronic sinusitis is confirmed when there is evidence of sinusitis on the CT scan. If the CT scan does not show evidence of sinusitis, see the rhinitis reason for referral.
    • Sinus x-rays are not an effective diagnostic test for this condition.
+-
Skin cancer
N/A
 
N/A
Skin Cancer
• Head and neck

Send referral to Edmonton Zone FAST Team or Dermatology as per zonal processes.
+-
Suspected head and neck cancer
List high risksymptoms
 
N/A
Suspected Head And Neck Cancer
• neck lump or facial mass
• oral and oropharyngeal mass or ulcer
• persistent hoarseness with history of tobacco and/or alcohol use
  • Refer to the Provincial Head & Neck Cancer Diagnosis & Referral Pathway to help guide the care of your patient prior to referral
  • Send referral to Edmonton Zone FAST Team
  • Oral lesions may be seen by Otolaryngology or Oral & Maxillofacial surgery.
  • If available:
    • CT neck ordered with contrast (indicate ordered in referral letter) but do not delay referral while waiting for CT scan.
  • Note: Some oral & maxillofacial treatments may not be covered through Alberta Health Care Insurance (i.e. dental fees).
  • Please refer to the Provincial Head & Neck Cancer Diagnosis & Referral Pathway for list of high risk
    symptoms.
+-
Suspected parathyroid disease
Serum calcium, PTH
 
Within 6 months of referral
Suspected Parathyroid Disease
• Hypercalcemia or elevated PTH or incidental imaging finding

Send referral to Edmonton Zone FAST Team
+-
Thyroid mass
TSH
 
Within 1 year of referral
Thyroid Ultrasound
 
Within 1 year of referral
Thyroid Mass
  • Send referral to Edmonton Zone FAST Team.
  • Fine needle aspiration if recommended based on imaging and availability

+-
Tinnitus
Audiogram (tinnitus and earfullness/pressure only)
 
N/A
Include the following information in the referral letter: - Otoscopy (normal/abnormal) - Previous ear procedures/surgery (right/left and details) - Hearing loss - History of ear infection - Vertigo - Ear Pain
 
N/A
Tinnitus
Consider referral for the following: unilateral tinnitus with associated hearing loss, or pulsatile
Send referral to Edmonton Zone FAST Team.

If available: Audiogram (discharge from the ear)
+-
Tympanic membrane perforation
Audiogram
 
N/A
Include the following information in the referral letter:- Tinnitus (right/left/none) |Draining ear (right/left/none) |Ear pain (right/left/none) (describe characteristics) |Otoscopy (normal/abnormal) |Previous ear procedures/surgery (right/left and details) |Previous history of head trauma or concussion | History of Temporomandibular joint disorder (ear pain only)
 
N/A
Tympanic Membrane Perforation
 >3 months duration
Send referral to Edmonton Zone FAST Team.
+-
Vertigo
Audiogram showing signs of hearing loss
 
N/A
Documentation of ear symptoms (i.e. tinnitus,ear pain)
 
N/A
Vertigo
With ear symptoms, i.e. hearing loss and ear pain

Send referral to Edmont Zone FAST Team or Vestibular Clinics as per zonal processes. See Alberta Referral Directory for information on vestibular clinics

If available: Assessment report and treatment response from vestibular physiotherapist.


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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