Clinical Resources
This section provides comprehensive information on a number of resources available to the members of the Fraser Health medical staff.

Forms

The forms listed here are related to accessing clinical services in Fraser Health facilities. This is NOT an exhaustive list. Please contact the relevant Fraser Health facility to enquire about clinical services documents which do not appear on this list. 

Forms

Ambulatory Procedures

Breast Health

Cardiac Services & Heart Health

Hematology Clinic

HIV AIDS Hepatitis C (Positive Health Clinic)

Laboratory Medicine

Lung Health 

Medical Day Care (MDC)

Neurology Referral Forms

Pain Clinic

Maternity Clinics (Perinatal)

Referral Forms

Renal/Vascular Access

Specialized Seniors Clinic

Surgical Procedures & Endoscopy

Urology

Advance Care Planning (ACP)

Advance Care Planning (ACP) is an overarching process for incapacity planning, and health care providers’ advance care planning, goals of care and serious illness conversations. It is a process that supports and encourages capable adults to talk over their beliefs, values, and wishes about the health care they wish to consent to or refuse, with their health care provider and substitute decision maker(s), in advance of a situation when they are incapable of making health decisions.

A variety of resources for health care professional as well as patients and families can be found on the Fraser Health intranet and internet sites:

Fraser Health Advance Care Planning

FH Pulse Advance Care Planning page (accessible through the FH network ONLY)

For Advance Care Planning forms, please click here.

Antimicrobial Stewardship

Welcome to the Fraser Health Antimicrobial Stewardship Program. Our purpose is to promote appropriate use of antimicrobials. In doing this, we hope to improve the outcomes of our patients, while minimizing adverse events and slowing the emergence of antimicrobial resistance.

Our website provides resources for clinicians and staff, including our locally developed and customized Antimicrobial Stewardship Handbook.

Our content is also available in the Firstline smartphone app, free for iOS and Android devices.

INTRODUCTION

TREATMENT GUIDANCE CHAPTERS

APPENDICES

Antimicrobial Stewardship Team

Kevin Afra
Medical Director, Antimicrobial Stewardship Program

Maggie Wong
ASP Pharmacy Coordinator

Anish Krishnan 
ASP Pharmacist

Tim Leung
ASP Pharmacist

Merisa Mok
ASP Pharmacist

Care and Discharge Planning (48/6)

Care & Discharge Planning (48/6) is a pro-active, integrated approach designed to prevent functional decline and in-hospital co-morbidity.  Consistent use of best practices in daily care and discharge planning is the most significant leverage point for improving flow and reducing hospital occupancy while improving the patient experience.   

What are the best practices in care and discharge planning?

  1. Timely, proactive and consistent screening and documented, goal-oriented care planning

  2. Supporting and promoting functional independence through Mobility Planning

  3. Use of patient bedside whiteboards to support 2-way communication with patients and families

    1. Ideally, an Estimated Discharge Date (EDD) is determined within 24 hours of admission as discharge planning begins at the time of admission.All admitted patients should have an EDD in place on both their care plans and bedside whiteboard within 48 hours of admission*

  4. Efficient, structured and effective patient rounds designed to ensure barriers to discharge are identified and allow patients to go home or to other care locations sooner. 

*For patients who do not have complicated health care needs, the Length of Stay Calculator (based on CIHI data, developed by Dr Spencer Lister) can be used.  Username: Web (No password required)

Most tools and processes have already been implemented to support best practices.

What is the purpose of the Pre-Admission Screening Questionnaire?

The Pre-Admission Screening Questionnaire helps the care team understand what the patient was like in the 6 key care areas 2 weeks prior to coming to the hospital. Knowing the pre hospital status of the patient is vital to care and discharge planning. Patient/family complete the screening questionnaire after a decision to admit has been made, within the first 48 hours of admission. The health care provider reviews the screening questionnaire, completes further assessment for areas of concern, and documents the issue and plan on the care plan.

  • Elective surgical patients complete the Patient Questionnaire (Adult) Pre-Surgical Health History form which includes the Pre-Admission Screening Questions.  
  • The revised Resident Transfer from Care Facility to Emergency Department form will support the transfer of information from residential care (RC) to acute care staff while ensuring 48/6 pre-admission screening is completed in a timely manner

 

What are the benefits for Physicians?

  • Increased efficiencies by providing more accurate and timely charting.  The Interprofessional Care and Discharge Plan is used by the entire health care team (including nursing staff, allied health and physicians) to document and communicate:

    • interventions/ actions required to address areas of concern/risk after screening and assessment are completed and

    • discharge needs and goals.

  • The goal is for all patients to have a care plan initiated within 48 hours of admission to hospital.

  • Improved communications and collaboration

  • Prepopulated care plan reference material aligned with established Pre Printed Orders (PPO), Clinical Decision Support Tools (CDST), and defined Care Pathways to inform evidenced based patient centred care plans

What are the benefits for Patients?

  • Improved quality and efficiencies in providing care

  • Reduced complications (eg. prevention of adverse medication-related events, decreased UTI rates, increased detection and treatment of delirium

  • Reduced length of stay

  • using standardized documents shared amongst all care teams improves patient transitions in care and decreases duplication

  • The use of patient bedside whiteboards engage patients and families in frequent, open transparent conversations which improve outcomes and satisfaction overall.

    • A highly visible EDD improves communication between care providers, the patient, and family members.

       

Frailty Management for Healthy Aging

Older adults do not need to experience frailty. It can be prevented and delayed with early detection and adequate support.

 

Fraser Health CARES (Community Action and Resources Empowering Seniors) is an evidence-based initiative that promotes healthy aging and decreases the impact of frailty on health care resources. CARES collaborates with primary care and acute care, assisted living, home health, researchers, community organization and EMR vendors to integrate holistic supports for healthy aging throughout the health care system.

These supports include the Electronic Comprehensive Geriatric Health Assessment (eFI-CGA) and Social Prescribing.

The eFI-CGA is a tool that calculates a frailty index score from a comprehensive geriatric assessment. It supports monitoring older adult patients’ heath status and frailty, and informs clinical decisions and wellness plan development. The eFI-CGI is integrated electronically into primary care EMR platforms and auto-populates with patient information.

Social Prescribing is a program that connects older adults to a range of local, non-clinical services, including social and physical activities, diet and nutrition programs, transportation services and caregiver supports. The program complements clinical treatments and other health authority services to address older adults’ needs beyond treating illnesses.

Once an older adult is referred to the program, a Seniors’ Community Connector (SCC) will work with them and their caregivers to identify their non-clinical needs and connect them to the most appropriate programs in their home community.

You can refer patients directly to an SCC through Pathways. Search ‘social prescribing’ under your community.

MAiD is a lawful and insured medical service that persons who meet the defined criteria will be able to access. Medical staff members who wish to provide MAiD consultations and/or services inside Fraser Health facilities will require privileges to do so.

Fraser Health MAiD Website

Bill C-14 - Passed by Parliament June 17/16

Bill C-17

 

Learning Hub Modules: MAiD: Roles and responsibilities for assessors and prescribers: This course is intended for those who are interested in learning about MAiD assessments and/or how to provide MAiD. Other Learning Hub courses are available that provide a general overview of MAiD and roles of other healthcare care professionals.

Education for New Assessors/Prescribers

Canadian Association of Maid Assessors and Providers (CAMAP) Conferences

 

All MAiD forms - Ministry of Health provincial forms

Patient Request Record

Patient Request Record (Large Print)

Assessment Record (Assessor) - First assessment required in eligibility process. MRP is not required to perform the MAiD provision. For additional information specific to the role of MRP in a patient's request for MAiD, please click here.

Assessment Record (Prescriber) - The prescriber (physician or nurse practitioner) is the practitioner who performs the MAiD procedure. 

Transfer of Request - This form is to be completed when a practitioner chooses to transfer patient's request for MAiD.

Consultant's Assessment of Patient's Informed Consent Decision Capability - Optional form when concern of patient's capability to provide informed consent.

Phone: 604-587-7878 
Email: mccc@fraserhealth.ca 
Fax: 604-523-8855

The Medical Assistance in Dying program is within the portfolio of the Regional Medical Director.

Mental Health and Substance Use

Fraser Health provides a range of mental health and substance use services that stretch across the life span and care continuums starting from prevention and health promotion to specialized, intensive in-patient care.

The services include in-patient and outpatient, community and residential services and are organized in 7 client service streams:

  • Child, Youth and Young Adult
  • Adult
  • Community Residential Emergency Short Stay and Treatment
  • Geriatrics
  • Substance Use
  • Tertiary (intensive and specialized services)
  • Housing

As well as owned and operated services, Fraser Health contracts and partners with community agencies and other Ministries (i.e. Ministry of Children and Family Development and Ministry of Social Development) to provide services that complete and complement its own.

Resources

The PSP Mental Health Module-Making it Real algorithm guides primary care providers in their practice with MHSU clients. The algorithm contains:

  • screening tools
  • self-management tools
  • decision making tools on how to assess and refer to specialized services.

This algorithm has been further adapted into a specific FHA algorithm with expanded MHSU sections.

PSP Mental Health Module-Making it Real Algorithm

The Collaborative Care Process Map will help guide FH MHSU clinicians to work collaboratively with the client’s PCP throughout the client’s “Episode of Care” with MHSU services. The Collaborative Care Process Map applies to community mental health centre programs and specifically when a client is receiving care from both the centre and a PCP. It applies to the entire client journey including referral to the centre, intake, ongoing care, and transition/discharge.

Collaborative Care Process Map

MICY – infant feeding decisions form

Infant Feeding Discussion Points

Feeding your baby: information to help with decisions

 

The Feeding Your baby – Information to help with decisions resources are now available on the Fraser Health Patient Education Resource Catalogue at the links below.   If you have this document on the Fraser Health Pulse (intranet) or www.fraserhealth.ca, please replace the link with the link found below. This will connect directly with the Patient Education Resource Catalogue where you are able to place an order or print a copy on your printer.  Once you have updated the link to the one above you will never need to update your link on the Fraser Health Pulse (Intranet) or www.fraserhealth.ca since this link on the Patient Education Resource Catalogue will house the newest version.

English (catalogue # 264467): https://patienteduc.fraserhealth.ca/search/results/109080

Hindi (catalogue # 264520):  https://patienteduc.fraserhealth.ca/search/results/112122

Korean (catalogue # 264517):  https://patienteduc.fraserhealth.ca/search/results/112119

Persian (catalogue # 264518):  https://patienteduc.fraserhealth.ca/search/results/112120

Punjabi (catalogue # 264513):  https://patienteduc.fraserhealth.ca/search/results/112116

Vietnamese (catalogue # 264514):  https://patienteduc.fraserhealth.ca/search/results/112117

Chinese Simplified (catalogue # 264516):  https://patienteduc.fraserhealth.ca/search/results/112118

Chinese Traditional (catalogue # 264521):  https://patienteduc.fraserhealth.ca/search/results/120796

Filipino (catalogue # 264519):  https://patienteduc.fraserhealth.ca/search/results/112121

Secure Messaging, Microsoft Teams for Clinical Use

All Fraser Health clinical users can now safely and securely communicate patient information with other clinical users using Microsoft (MS) Teams chat. MS Teams is Fraser Health’s secure, encrypted and approved communications tool required for messages that may contain patient health information.

Over 10,000 Fraser Health clinical users access MS Teams for secure messaging every month, with 300,000 messages sent per week and significant use of the voice and video functionality.

MS Teams replaced MicrobloggingMD (MBMD) which was decommissioned on March 31, 2022 for secure messaging. MS Teams is the preferred Fraser Health communications tool, and replaces unauthorized and unsecured communications apps.

Use case examples:
  • Hospitalists can text a peer regarding a patient using the patient’s name and condition details.
  • Emergency Department physicians can text the on-call Specialist for a patient consult.
  • Community Health workers can text a Licensed Practical Nurse regarding a patient during a client call.
  • Community Health Schedulers can text schedule changes to Community Health Care Workers.
Microsoft Teams, Secure Messaging now integrates with the OnCall Scheduling System to display specialist on-call availability information for physicians. The app displays up to four days of schedules allowing users to open up a chat message with a single tap of the finger within MS Teams.
 
In Q3, 2022, non-acute Family Practice Clinics and staff will be offered access to MS Teams. Expanding access to community providers opens communication horizons allowing Fraser Health and community clinical users to efficiently interact through MS Teams.
Resources

Secure Messaging Pulse page: Set-up guides, training videos, FAQs, OnCall app

Microsoft Teams Pulse page: Set-up guides, training videos, and more

Library Services

Library Services offers many research tools and services.

Our Services

Fraser Health Library Services are available to all physicians & staff.

We provide article and book retrieval, literature searches, and research assistance.

We also provide access to medical databases, electronic apps such as UpToDate, & other resources. Library staff are also available for training and education in relation to our services.

Our Staff

There are eight library staff to support you, located at six library sites.

We support all Fraser Health sites, be it hospital, community health location, or administration center.

Our Digital & Print Resources

Library Services provides access to almost 4,000 electronic journals to support your education, professional development, and patient care practice.

We also hold print collections of books and journals that are available for loan across all Fraser Health Authority. Click here for our library catalogue.

Electronic Resources

Databases may contain citations and/or full-text articles. You can access full-text articles through the following Fraser Health subscription (secured) databases and free online databases. * Passwords are needed to remotely access secured databases . To access databases from your home or off-site office, contact library staff to get a username and password.

For external access, please contact Library Services.

A-Z Online Journals

EBSCO A-to-Z® is a locator tool listing all of a e-HLbc's e-resources, including e-journals, titles in full-text databases, publisher packages, etc. The easy-to-navigate, searchable list of journals allows end users to quickly find any journal or resource, even those buried in a database.

Biomedical Reference Collection

Full-text journals covering such disciplines as clinical medicine, nursing, dentistry, veterinary medicine, pre-clinical sciences and the health care system.

CINAHL

CINAHL® with Full Text provides indexing for 2,818 journals from the fields of nursing and allied health. All journals in this collection are selectively indexed in CINAHL. CINAHL Select has been added to all customers who subscribe to CINAHL with Full Text providing cover-to-cover full text for the journals that are indexed selectively in CINAHL with Full Text.

Cochrane Systematic Reviews

Cochrane Database of Systematic Reviews is one of the most important databases in evidence-based medicine. It is on par with MEDLINE in the view of many and provides quick access to the systematic reviews of randomized controlled trials (RCTs) undertaken by the international Cochrane Collaboration. Its strength is providing easy access to RCTs that deal with drugs, interventions and therapies.

EMBASE

EMBASE - the Excerpta Medica database - is an international (but European focused) biomedical and pharmacological database that provides access to the most up-to-date information about medical and drug-related subjects. Comprehensive inclusion of drug-related information makes EMBASE particularly valuable, with coverage of 5,000+ biomedical journals from 70 countries.

Evidence-Based Medicine Reviews (EBMR)

EBMR, a definitive resource in evidence based medicine, combines 7 of the most trusted EBM resources into one databases. Search all at once or separately.

HealthStar

A database that contains citations to the published literature on health services, technology, administration, and research. It focuses on both the clinical and non-clinical aspects of health care delivery.

LexiComp

Concise and in-depth clinical content allows pharmacists, physicians and nurses to find answers quickly and efficiently while making safer medication decisions.

Medline (Ovid) & Medline (EBSCO)

MEDLINE® (Medical Literature Analysis and Retrieval System Online) is the U.S. National Library of Medicine's® (NLM) premier bibliographic database that contains approximately 12 million references to journal articles in life sciences with a concentration on biomedicine. Articles cover topics in medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences, and much more.

Both links connect to the MEDLINE database, under the different search platforms of EBSCO and Ovid.

PsycARTICLES

Full-text articles in general psychology and specialized, basic, applied, clinical and theoretical research psychology, as well as psychiatry.

PsycINFO

The PsycINFO database contains almost 2 million references to psychological literature from 1887 to present, from journal articles, books, book chapters, technical reports, and dissertations.

UpToDate

Accessible from home and mobile devices once account is set up. Contact library staff for assistance.

UpToDate covers more than 7,400 topics in 13 medical specialties and includes more than 76,000 pages of text, graphics, links to Medline abstracts, more than 254,000 references, and a drug database. Physician editors and authors review and update the content continuously. An updated version of UpToDate is released every four months.

ERIC 

The Education Resources Information Center (ERIC), sponsored by the Institute of Education Sciences (IES) of the U.S. Department of Education, produces the world's premier database of journal and non-journal education literature. Search the ERIC bibliographic database of more than 1.1 million citations going back to 1966.

Google Scholar

Google Scholar provides a simple way to broadly search for scholarly literature.You can search across many disciplines and sources: peer-reviewed papers, theses, books, abstracts and articles, from academic publishers, professional societies, preprint repositories, universities and other scholarly organizations.

Health Services/Technology Assessment Text (HSTAT)

Health Services Technology Assessment Texts (HSTAT) is a full text database of guidelines, technology assessments and evidence-based medicine reports developed by the United States National Library of Medicine (NLM).

International Bibliographic Information on Dietary Supplements (IBIDS)

The IBIDS database provides access to bibliographic citations and abstracts from published, international, and scientific literature on dietary supplements. IBIDS is a collaboration between two US government agencies: the Office of Dietary Supplements of the National Institutes of Health, and the Food and Nutrition Information Center (FNIC) of the United States Department of Agriculture's (USDA) National Agricultural Library (NAL).

MedlinePlus

MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.

Merck Manuals Online Medical Library

The Merck Manual of Diagnosis and Therapy covers all the subjects expected in a textbook of internal medicine as well as detailed information on pediatrics, psychiatry, obstetrics, gynecology, dermatology, pharmacology, ophthalmology, otolaryngology, and a number of special subjects.

Online Mendelian Inheritance in Man (OMIM)

A catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere, and developed for theWWW by NCBI, the National Center for Biotechnology Information. The database contains textual information and references, as well as links to MEDLINE and sequence records in the Entrez system, and links to additional related resources at NCBI and elsewhere. OMIM is intended for use primarily by physicians and other professionals concerned with genetic disorders, by genetics researchers, and by advanced students in science and medicine.

PubMed

This is an excellent free version of Medline from the U.S.National Library of Medicine.

REHABDATA

The database covers documents describing physical, mental, and psychiatric disabilities, independent living, vocational rehabilitation, special education, assistive technology, law, employment, and other issues as they relate to people with disabilities. Published by the National Rehabilitation Center.

TOXNET

TOXNET (TOXicology Data NETwork) is a cluster of databases covering toxicology, hazardous chemicals, environmental health and related areas. Published by the U.S. National Library of Medicine.

Research Workshops

Got Library? An Introduction to Library Resources

A collection of short online lessons to introduce learners to Fraser Health's Library Services. Lessons focus on a variety of services and resources available to Fraser Health employees and physicians in support of patient care, decision making and research.

 

Using Library Search Tools (Online) - Basic and Intermediate Levels

*Please note, these courses use sound. A private computer or headphones is recommended*

By the end of these online sessions, you will know how to:

Basic Level (30 Mins)

  • Find the library web pages on FH Pulse
  • Access research databases
  • Run searches using keywords
  • Find articles
  • Contact library staff

Intermediate Level (30 Mins)

  • Find appropriate subject headings
  • Combine subject headings and keywords to make complex searches
  • Narrow your search using limits
  • Find your article from a citation

Advanced Level (30 Mins)

  • Use PICO to develop your search question
  • Improve your search results with explode, major concept, wildcare, and truncation
  • Find full text articles from outside the databases

To make sure that you can use all of the resources included in this course, please use a Fraser Health networked computer.

 

Email Library Services to schedule a one-on-one tutorial, or team training on these topics and more: 

  • Copyright guidance
  • Everyday evidence-based practice
  • Library orientation
  • Managing citations
  • Pearl growing
  • Finding drug information
  • Using databases to find articles (CINAHL, MEDLINE, etc.)
  • UpToDate

For current Department of Evaluation and Research Services Workshops, please go to LearningHub and select Research Skills under Category.

Contact a Librarian

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Jim Pattison Outpatient Care & Surgery Centre

JPOCSC-(1).jpg

The Jim Pattison Outpatient Care and Surgery Centre (JPOCSC), located in Surrey, BC, offers a one-stop approach to outpatient care. We offer day surgery and diagnostics, with specialty services and community health clinics, all under one roof.

Click here for a listing of the clinics and services at JPOCSC.  Referral, booking and requisition forms are available through the forms section on this site.

Resources

Patient Education Catalogue

In this catalogue you will find patient education resources used by healthcare professionals in the Fraser Health Authority (FHA).

Soonest Surgery Tool

The Soonest Surgery Tool is a joint initiative of the Fraser Health Surgery Program, and PHSA’s Surgical Patient Registry and Performance Monitoring & Reporting programs.

B.C. Guidelines

B.C. Guidelines are clinical practice guidelines and protocols that provide recommendations to B.C. practitioners on delivering high quality, appropriate care to patients with specific clinical conditions or diseases.