Practice Guidelines

Practice Guidelines Disclaimer

These Clinical Practice Guidelines are intended for use by physicians and other health care providers to assist in clinical decision-making. The information is not designed or intended for the general public and should not be considered, or used as a substitute for, medical advice.  Individuals are advised to always seek the advice of a physician or other qualified health care provider for specific information on personal health matters.

Clinical Practice Guidelines are based on scientific evidence current as of the date issued and are subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.

Any person consulting or applying the Clinical Practice Guidelines is expected to use independent medical judgment and expertise in the context of individual clinical circumstances.  Winnipeg Regional Health Authority (“WRHA”) makes no representation or guarantees of any kind whatsoever regarding the content or use or application of the Clinical Practice Guidelines and specifically disclaims any responsibility for their application or use in any way.

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Routine Preoperative Tests for Adult Patients Undergoing Elective Surgery

• Routine Preoperative Tests for Adult Patients Undergoing Elective Surgery – Clinical Practice Guideline
• Preoperative Lab Test Guideline – Algorithm
• Preoperative History & Physical Form (If you are in Fee For Service practice please contact your vendor for assistance uploading the revised form in your EMR.)
• PreOp H&P Form Completion Guide
• Canadian Anesthesiologists Society Recommendations – Choosing Wisely 2015
• Surgery Program Preoperative Assessment and Patient Questionnaire

Practice Guidelines

PCPG #1: Cerumen Management Guideline

• Appendix A – Bilingual Version

PCPG #2:  Emergency Management of Hypoglycemia In the PC Setting

• Appendix A – Treatment Guidelines for Hypoglycemia for Patients Less Than 5 Years
• Appendix B – Treatment Guidelines for Hypoglycemia for Patients Greater Than 5 Years

PCPG #3:  Process for Practice Guideline Development

• Appendix A – PC Practice Guideline Template
• Appendix B – Development Summary

PCPG #4: Emergency Management of Anaphylaxis in the Primary Care Setting:

• Please follow “Management of Suspected Anaphylaxis in WRHA Population and Public Health Practice Guideline

PCPG #5:  Emergency Management of Asthma in the Primary Care Setting

• Appendix A – Treatment Guidelines for Asthma

PCPG #6:  Emergency Management of Chest Pain in the Primary Care Setting

• Appendix A – Treatment Guidelines for Chest Pain

PCPG #7:  Emergency Management of Seizure in the Primary Care Setting

• Appendix A – Treatment Guidelines for Seizure

PCPG #8:  Emergency Management of Pediatric Febrile Seizure in the Primary Care Setting

• Appendix A – Treatment Guidelines for Pediatric Febrile Seizure
• Appendix B – Parental Education for Pediatric Febrile Seizure

PCPG #9:  Oral Anticoagulation Therapy

PCPG #10:  Point of Care Testing Blood Glucose Monitoring

• Appendix A – Current vs New Stat Strip
• Appendix B – Glucose Monitor FAQs
• Appendix C – Stat Strip Presentation
• Appendix D – User Glucose Competency Training
• Appendix E – Stat Strip 175 Quick QC Guide 2 Canada
• Appendix F – Stat Strip 175 Quick Operation Guide 2 Canada
• Appendix G – Troubleshooting Guide

PCPG #11:  Use of Automated External Defibrillator for Sudden Cardiac Arrest (Adults)

• Appendix A – Zoll AED Plus AED
• Appendix B – Zoll AED Plus Setup and Practice Videos – Clinic Team to review the following 2 videos:
  • Outside the Box – Setup, test, inspect and install the AED Plus
  • Inside the Rescue – Demonstration and Practice
• Additional Copies of the Zoll AED Plus Administrator’s and / or Operator’s Guide Product Manuals go to: http://www.zoll.com/medical-products/product-manuals/?pid=9493
• Appendix C – Zoll AED Plus Checklist

PCPG #12:  Implementation and Management of Tobacco Use and Dependence

• Better Breathing Survey
• Appendix A – Stages of Change to Quit or Reduce Smoking
• Appendix B – Terms used in the Lifestyle Band
• Appendix C – Tobacco Reduction Cessation Entry into EMR
• Appendix D – Tobacco Assessment and Management
• Appendix E – Tobacco Reduction Resources
• Appendix F – CHA Program Description
• Tobacco Cessation Tips, Tools, Techniques
• 5A’s 5 R’s Table WHO
• Tobacco Cessation in Primary Care – Cessation Medications
• Smoking Cessation – Reduction Medication Dosing Fact Sheet
• Algorithm for Tailoring Pharmacotherapy in Primary Care Setting
• Cannabis Education
  • Memo Re: Cannabis Education
  • CCSA Marijuana Fact and Fiction Infographic
  • Cannabis Parent Talk Kit
  • Cannabis The Basics
  • Clearing the smoke
  • Cannabis Letter AFM Package
  • CCSA LRCUG Infographic
  • Action Tips for Parents
  • Cover Letter to Schools
  • CCSA Know Health Effects Marijuana Infographic
  • AFM Youth Services Brochure
  • MPI 5 Myths

PCPG #13:  Ebola Virus Disease – Clinical and Operational Toolkit

• Primary Care Setting EVD Clinical Process Algorithm
• Ebola Virus Disease Preparedness Checklist for the Clinical setting
• FM/PC Patient Travel/Contact History-EVD Form
• Ebola Fact Sheet for the Public – English
• Ebola Fact Sheet for the Public – French

PCPG #14:  Management of Behavioural Emergencies Toolkit Adult

• Appendix A – Triage Scale of Behavioural Emergencies
• Appendix B – Pharmacologic Treatment of Behavioural Emergencies
• Appendix C – Wellness Recovery Action Plan
• Appendix D – Guide to Complete Form 4 and Form 21
• Appendix E – Defusing-Event Review ID Card

PCPG #15:  Process for Monitoring INH administration in adults being treated for LTBI

PCPG #16: Spirometry Testing – Adult

• Appendix A – EMR Case Finding Approach
• Appendix B – Spirometry Screening Tool and Patient Handout
• Appendix C – The Role of Clinics RRT and PHC in Spirometry
• Appendix D – Spirolab Spec Sheet
• Appendix E – Spirometer Quality Control Log
• Appendix F – Quarterly Spirometry Report Template
• Appendix G – Spirometry Testing – Adult
• Pulmonary Function Test Forms

PCPG #17:  Emergency Management of Opioid Overdose using Naloxone Kit Use

• Appendix A – Treatment Guideline for Opioid Overdose
• Appendix B – Opioid Assessment Tool for Naloxone Take Home Kit
• Appendix C – Educational Session for Naloxone Take Home Kit EMR
• Appendix D – Naloxone Service Algorithm

PCPG #18: Process for Monitoring Rifampin Administration in Adults for the Treatment of LTBI

PCPG #19: Falls Prevention

• Appendix A – Community and Ambulatory Care Client Falls Risk Screening Tool
• Appendix B – Your Fall Risk Factors
• Appendix C – Environmental Checklist for Falls Prevention
• Appendix D – Environmental Checklist for Falls Prevention – Construction or Renovation Planning
• Appendix E – Falls Risk Actionable Query
• Appendix F – Falls Risk Flag
• Appendix G – Falls Risk Screening and Documentation Algorithm

PCPG #20:  Implementation of Well Baby Well Child in the EMR

Well Baby 3 day old Newborn Visit to Well Baby 1 month old Visit

• Appendix B – Well Baby – 3 day old visit
• Appendix C – Well Baby – 1 -2 week old visit
• Appendix D – Well Baby – 1 month old visit
• Appendix E – Well Baby Suggested Resources Birth to 1 month old

Maternal – 6 week postpartum Visit to Well Baby 6 month old Visit

• Appendix F – Maternal 6 week postpartum visit
• Appendix G – Well Baby – 2 month old visit
• Appendix H – Well Baby – 4 month old visit
• Appendix I – Well Baby – 6 month old visit
• Appendix J – Well Baby Resource List 2 months – 6 months old

Well Baby 9 month old Visit to Well Baby 12 month old Visit

• Appendix K – Well Baby – 9 month old visit
• Appendix L – Well Baby 12 month old visit
• Appendix M – Well Baby Resource List 9 months – 15 months old

Well Baby 18 month old Visit to Well Child 4 – 5 years old Visit

• Appendix N – Well Baby 18  month old visit
• Appendix O – Well Baby – 2 – 3 year old visit
• Appendix P – Well Baby – 4 – 5 year old visit
• Appendix Q – Resource List 18 months – 5 years old

Additional Resources

• Appendix R – Health Care Professional Tips and Red Flags
• Appendix S – Well Baby/Child Resource Reference Sheet for Accordian
• Appendix T – Well Baby/Child Documentation to Support Tracking Visits
• Appendix U – How to Use the Well Baby/Child System

PCPG #21 – Pending

PCPG #22: Prophylaxis Protocol for Adult Post-Exposures to Blood and Body Fluids

• Appendix A – Primary Care PEP Preparedness Checklist
• Appendix B – Post Exposure Prophylactic Accuro EMR Workflow
• Appendix C – Follow-up Assessment of Blood or Body Fluid Exposure Algorithm
• Appendix D – Introduction-Instruction-Follow-up Blood or Body Fluid Exposure (Post Exposure Prophylaxis Protocol – PEP)
• Appendix E – Source Consent Script
• Appendix F:
  • PEP follow-up Clinical Note Templates – One week follow-up
  • PEP follow-up Clinical Note Templates – Four week follow-up
  • PEP follow-up Clinical Note Templates – Twelve week follow-up
  • PEP follow-up Clinical Note Templates – Twenty-four week follow-up

Operational Guidelines

PCOG #1: Patient Access and Transfers

• Appendix A – Algorithm for attaching patients
• Appendix B – Request for Consultation/Referral (WCC – 00059)

PCOG #2: Third Party Billings

• Appendix A -Third Party Tracking Spreadsheet
• Appendix B – Reminder to Insurer
• Appendix C – Notice of Write Off to Provider

PCOG #3:  Process for Operational Guideline Development

• Appendix A – Operational Guideline Template
• Appendix B – Development Summary

PCOG #4:  MIS Monthly Data

• Appendix A – Primary Care MIS Monthly Statistics

PCOG #5:  Management Telephone Inquiries

• Appendix D1 – PC Same Day Appointment Algorithm
• Appendix D2 – QCC Same Day Appointment Algorithm

PCOG #6:  Emergency Response Training in Primary Care

• Appendix A – General Emergency Response Protocol in Primary Care Settings

PCOG #7:  Patient Chaperones during intimate physical examination

• Chaperone Poster

PCOG #8:  Emergency Cart – Equipment, Supplies & Medication Operational Guideline

• Emergency Supply List
• Emergency Cart Checklist

PCOG#9: Mental Health Wait Time Reporting

• Appendix A – Mental Health Referral Algorithm
• Appendix B – Mental Health Wait Time Reporting
• Appendix C – Mental Health Referral Information Form
• Appendix D – Mental Health Wait Time Reporting Export Instructions
• Appendix E – Mental Health Wait Time-Template, Manual Reporting

PCOG #10:  Patient Status Criteria

• Appendix A – Patient-Client Status
• Appendix B – Merge a Patient
• Appendix C – Deceased Client Notification – Quick Reference Guide

PCOG #11:  RESULTS MANAGEMENT – Critical Result, Test or Report Values

• Appendix A – When to Use EMR Mail Messages vs. Tasks
• Appendix B – EMR Optimization of Critical Result, Test and Report Values
• Appendix C – Critical Result Follow-up Audit Template
• Appendix D – Linking Documents to a Diagnosis
• Appendix E – Provider Review of Manual INR Results

PCOG #12:  Advanced Access Strategies

• Appendix D – High Leverage Changes for Primary Care Process Review (Worksheet)
• Appendix E – Plan/Do/Study/Act (PDSA) Tool
• Appendix F – Measurement Guide for Reporting AA and MIS
• Advanced Access Orientation and Refresher
• Strategies to Reduce No-Shows and Missed Opportunities

PCOG #13:  Basic Life Support Training

PCOG #14:  Medication Storage, Restocking, Disposal and Return

• Appendix A – Medication Storage, Restocking, Disposal and Return AUDIT
• Appendix B – Outline of Prescription Regulations (All Non M3P)
• Appendix C – Outline of Prescription Regulations (M3P)
• Appendix D – Loss or Theft Report Form for Controlled Substances

PCOG #15:  Therapeutic Patient Relationships

PCOG #16:  Client Follow-Up – Duty of Care

• Appendix A – Emailing Personal Health Information Guideline
• Appendix B – Texting With Individuals Receiving Health Care Services from WRHA

PCOG #17:  Scanning Historical Documents Into the EMR

• Appendix A – Caution Flag for paper record
• Appendix B – Document Folders and Sub Folders
• Appendix C – Workflow
• Appendix D – Documents Screen View
• Appendix E – Importing PDF Documents from Historical Electronic Charts

PCOG #18:  Transfer of Patients to Emergency Departments

• Appendix A – Aid to Capacity Evaluation (ACE)
• Appendix B – Emergency Department Crisis Response Services Transition Summary
• Appendix C – Guide to completing Crisis Response Services Transition Summary

PCOG #19:  Scale Calibration and Maintenance

• Appendix A – Patient Scale Template

PCOG #20:  Medical Remuneration Processes – Independent Contracts and Sessional

• Appendix A – Medical Remuneration Schedule 2022
• Appendix B – Ad Hoc Submission Form
• Appendix C – Contract Hours Tracking Spreadsheet
• Appendix D – Contract Summary

PCOG #21:  Primary Care Team Member Access to eChart

• Appendix A – Primary Care Team Member eChart Access Matrix
• Appendix B – eChart Manitoba Access Matrix
• Appendix C – Pathway for determining level of user access

PCOG #22:  “Home for the Summer” Program – Medical Students

PCOG #23:  Client Identification

• Posters – Patient Identification

PCOG #24:  Research and Evaluation

PCOG #25:  Enrolment Process in Primary Care

• Appendix A – Accuro Enrolment Reference Guide
• Appendix B – Your Home Clinic, Enrolment Tool

PCOG #26:  Remote Access to EMR

• Appendix A – Remote Access Form

PCOG #27:  Physician Scheduling and Job Sharing

• Appendix A – Physician TAF and WSA Request Form SAMPLES
• Appendix B – Physician TAF and WSA Process ALGORITHM

PCOG #28:  Kanban Inventory System

• Appendix A – 5S Tool
• Appendix B – Red Tag Area
• Appendix C – Red Tag Area Instructions
• Appendix D – Kanban Supplies Procedures

PCOG #29:  Optimizing Team Roles through Appointment Types and Reasons

• Appendix A – Team Huddles – How To and Tips
• Appendix B-1 – Primary Care Client Appointment Booking Guide
• Appendix B-2 – WICC Client Appointment Booking Guide
• Appendix C – EMR Booking of Appointments
• Appendix D – Rooming Criteria Guide
• Appendix E
  
  • Bank of Appointment Types
  • Bank of Appointment Reasons

PCOG #30:  Results Management – Outstanding Orders

• Appendices A & B – Procedures Workflow and Typical Wait Times

PCOG #31:  Latex Safe Environments

• Appendix A – Latex Safe Checklist
• Appendix B – Latex Safe Signage
• Appendix C – Latex Allergy Checklist
• Appendix D – Response re: Latex Content of BD Products
• Working Towards a Latex Safe Environment

PCOG #32:   Optimizing EMR Tasking Generating Consult Referral Letters and Documentation Best Practices

• Appendix A – Consult and Referral Request Letters
• Appendix B – Generate Consult – Referral Letter June 2014
• Appendix C – Documentation Best Practices in the Community EMR
• Appendix D – Communication from Walk-In Connected Care to PCHP

PCOG #33:   Appropriate Use of the Electronic Medical Record By Role

• Appendix B – Primary Care Quality Indicators – Mapping Details

PCOG #34:   Electronic Signatures

• Appendix A – Medical Directive – Electronic Signatures

PCOG #35:   Fax Machine – Operation and Downtime Procedure

PCOG #36: Manitoba Family Physician Chart Review

• Appendix A – CPSM Quality Improvement Program Algorithm

PCOG #37:   Workplace Violence Prevention

• Appendix A – Care Alert Flag Documentation Requirements
• Appendix B – Person of Interest Tool

PCOG #38:   Primary Care Dashboard

#PCOG39: Locum Services

• Appendix A – Ad Hoc Submission Form
• Appendix B – Electronic Funds Transfer
• Appendix C – Letter of Agreement
• Appendix D – Guidelines and Expectations
• Appendix E – Request for Locum
• Appendix F – Attending Physician Feedback Survey
• Appendix G – Locum Physician Feedback Survey

PCOG #40:  Prevention and Treatment Group Education Sessions

• Appendix A – Creating, Booking and Managing Group Education Session Appointments
• Appendix B – A Guide to Editing in WordPress – Health Management Group Programs
• Appendix C – Group Education Program Tracker
• Appendix D – Program Outline EXAMPLE Craving Change
• Appendix E – Adding Documentation for Group Education using Report Query and Clinical Note Template
• Appendix F – Pre-Group Program Letter Macro
• Appendix G – Post-Group Program Letter Macro
• Appendix H – Outcome Measures Evaluation Tool

PCOG #41: Medication Reconciliation

• Appendix A: Medication Reconciliation in the EMR

PCOG#42 WICCC Wait Time Portal Clinic Management  

Appendix A – WICCC Wait Time Portal Clinic Management Guide