Information for health care professionals

The www.urgentcareontario.ca services are only for individuals that have an urgent medical issue but cannot see their family doctor due to availability or they do not have a family doctor.

We inform all patients that their first point of contact should always be their family doctor if they have one and they are available. We know family doctors are the most familiar with the personal and medical history of their patients, and often have a lengthy relationship with them. Patients seen through www.urgentcareontario.ca are told to follow up with their family doctor if necessary.

For any adults who see an www.urgentcareontario.ca doctor, the assessment notes from the visit are shared with the patient’s family physician through fax within 24 hours.

If during the www.urgentcareontario.ca visit, the patient is told they need to attend an emergency department for further assessment, they will be instructed to come in person and follow the same triage process as any other patient accessing the emergency department without a virtual assessment. Assessment notes will be faxed or emailed to the patient’s emergency department care team.

Please see our FAQ page for more information about our services.

The www.urgentcareontario.ca services are only for individuals who have an urgent medical issue, but cannot see their family doctor due to availability or do not have a family doctor.

We inform our patients that their first point of contact should always be their family doctor if they have one and they are available. We know family doctors are the most familiar with the personal and medical history of their patients, and often have a lengthy relationship with them. Patients seen through www.urgentcareontario.ca are told to follow up with their family doctor if necessary.

For any children or youth who see an www.urgentcareontario.ca children’s emergency doctor, the assessment notes from the virtual visit are shared with the patient’s family physician through fax within 24 hours.

If the www.urgentcareontario.ca child/youth patient needs to go to an emergency department in-person for further assessment, they will be told to go to their closest hospital emergency department, as appropriate. Parents and children will need to follow the same triage process as any other patient accessing the emergency department without a virtual assessment. Assessment notes from their virtual visit will be available to the care team at the hospital.

Overview of Program

LTC-CARES (Consults and Recommendations for Emergency and Support Services) is designed to improve access to hospital level acute care resources for residents of long-term care and other congregate care setting* homes in the Hamilton and Niagara North West areas. This program can optimize care for residents while reducing unnecessary transfers and long waits in the emergency department. The program is available 9 a.m. to 9 p.m. daily including holidays.

This program offers urgent consultations with emergency department doctors. Residents experiencing medical emergencies should be transferred to the emergency department via a 911 call.

*Model for congregate settings such as retirement homes under development

Who is this program for?

This program is intended for residents of long-term care or other congregate care setting* homes in the Hamilton and Niagara North West areas. The program provides family doctors and nurse practitioners with remote access to an emergency department doctor for urgent consultations. Consent from the resident, power of attorney or substitute decision maker is required.

How is LTC-CARES accessed?

A simple telephone call to 1-844-CARE-844 or locally to (905) 521-5030 will connect you with paging at Hamilton Health Sciences. Ask for the LTC-CARES emergency department doctor on call and you will be connected with the LTC-CARES team.

How does LTC-CARES work?

Once you have contacted the LTC-CARES doctor or team member you will be asked to provide information such as the resident’s demographics. The team will guide you on this at the time of the call.

The consultation may be as easy as the doctor or nurse practitioner connecting with the LTC-CARES doctor by telephone and will begin as soon as the patient is registered. Other options include teleconference, to include the resident’s nurse and video conference (OTN or Zoom Healthcare), to include the nurse and resident.

Once the consultation has occurred, a plan of care will be agreed upon by the doctor and/or nurse practitioner. The LTC-CARES nurse will coordinate and communicate any required follow-up with the resident’s home.

What type of situations can LTC-CARES help with?

A call to LTC-CARES will connect you with an emergency department doctor for consultation and support in developing a plan of care that could include referrals to specialty services that are typically accessed on an urgent basis through an emergency department visit.

Some examples include:
• An acute exacerbation of a chronic illness (chronic obstructive pulmonary disease, diabetes, heart failure) that could be managed in the home if more frequent labs and/or an expedited specialist follow-up appointment could be arranged
• An acute illness (possible pneumonia, urinary tract infection or other infection) requiring consultation regarding acute management
• Low hemoglobin, in a resident without active bleeding that may require transfusion, but could wait to be arranged in a medical day unit within a few days
• An upper extremity fracture that could be managed with a splint or sling and a virtual fracture clinic visit within a few days
• A fall with no significant injuries to determine whether an emergency department visit is needed for a CT scan or other imaging
• A G-tube concern that could be managed through an outpatient appointment in interventional radiology

Please note that follow-up consultations or appointments may be done remotely or may require an in-person appointment; both options would avoid travel to an emergency department and long wait times.

Aside from an emergency department doctor consultation, what other services are available?

The LTC-CARES program operates between 9 a.m. to 9 p.m. daily and is supported by local emergency department doctors along with expedited local specialty service follow-up such as internal medicine, cardiology, respirology, geriatrics, orthopedics, radiology, and palliative care. In addition, expedited access to mobile investigations is available through our partners at LifeLabs and STL Diagnostics (X-ray and ultrasound).

How much involvement does the on-call LTC or congregate care setting* doctor or nurse practitioner have with the care planning?

The home’s doctor or nurse practitioner is required to participate in the consultation and care planning with the LTC-CARES emergency department doctor as they continue to be the resident’s most responsible provider. They will be connected by phone or through OTN or Zoom Healthcare.

Do I have to use video technology to access LTC-CARES?

No, most times a telephone call is all that is required. We also have a conference line dedicated to the LTC-CARES program to allow multiple health care providers, patients and/or family (as appropriate) to participate on the call. If video technology is required, our LTC-CARES team can walk you through the process.

What is the call-back time like after we have called paging?

Once you call paging, you will usually be connected immediately with the team or the on-call doctor. In the event an immediate connection does not occur, the call back time should be within 30 minutes. If you have not heard back within 30 minutes, something has gone wrong, please call paging again.

What information do I need to have ready when I call?

Resident information including name, date of birth, health card #, health concern, vital signs, your assessment and the medication record. Additionally, have the resident’s chart available during the call to help answer any additional questions about medical history and finally, confirm resident/power of attorney/substitute decision maker consent.

Long-term care or other congregate setting* site information including home name, address, telephone number, email address (if video conference is required), and doctor/nurse practitioner contact name and number.

Who is responsible for the resident when LTC-CARES is called?

The resident’s family doctor or nurse practitioner remain the most responsible provider for the resident while the emergency department doctor provides a consultation. The LTC-CARES team will work with the resident’s family doctor or nurse practitioner to help develop a plan of care in addition to expediting required hospital-based follow-up appointments.

What hours of the day is this service available?

The LTC-CARES program is available 12 hours a day/7 days per week between 9 a.m. and 9 p.m. daily.

*Model for congregate settings such as retirement homes under development.