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Mental Health and Addictions Nurses (MHAN) Referral Form
South West Mental Health and Addictions Nurses (MHAN) Referral Form
Palliative Care – Community Services Assessment Request
Page 1 of 3 2023SEP15.V005 356 Oxford Street West London, ON N6H 1T3 Telephone: 1-800-811-5146 Fax: 519-472-4045 Palliative Care – Community Services Assessment Request Important Instructions • Referrals without sufcient information will be returned to the referra l source with further direction. • Responsibility for medical care will remain with the primary care pr ovider unless otherwise notifed. • Hospital referrers, please contact the Ontario Health atHome hospital care coordinator prior to discharge for an assessment to inform service planning. Please complete the referral form in its entirety and fax completed form to Ontario Health atHome : 51 9-472-3257 ** The referral will be triaged based on the information provided in this form ** Attach relevant documents to support this referral (e.g. consult notes, current medication list, imaging results, etc.) Patient Information Surname First Name Date of Birth (DD-Month-YYYY) Home Address CityPostal Code Health Card Number Version Code Phone Number Does the patient prefer/need an alternate contact? If yes, indicate in th e Alternate Contact Information section. Assigned sex at birth No Ye […]
ESC-Medication-Safety-EN
07-2024 Medication Safety Information for patients How to safely manage your medications Keep an up-to-date list of all your medications such as prescriptions, vitamins, over-the-counter medications, or natural health products. Include the medication name, dose, and how and when you are taking the medications. Keep this list with you at all times […]
Medication Safety – English
07-2024 Medication Safety Information for patients How to safely manage your medications Keep an up-to-date list of all your medications such as prescriptions, vitamins, over-the-counter medications, or natural health products. Include the medication name, dose, and how and when you are taking the medications. Keep this list with you at all times […]
WW-031B-request-for-hospice-pallaitive-care-services
Waterloo Wellington Form 031B Request For HPC Services
Form 031B Request For HPC Services – English
Waterloo Wellington Form 031B Request For HPC Services
OHaH-Family-Managed-Home-Care-Fact-Sheet-EN
[…] providers in the hom e, including establishing contingency plans. z Able to fully understand and carry out the responsibilities of being an employer, often of multiple care providers. z Capable of managing the fnancial aspects of the program, including the bank account, payment of care providers/agency and taxes, securing insurance, record-keeping and fulflling Ontario Health atHome’s reporting requirements. z Able to use a computer, spreadsheet, scanner, send and receive emails with attachments, name computer fles and enter billing and invoice information in the manner and method requested by Ontario Health atHome (e.g., can be by email or through an online portal). Other Information z The hours and services in the care plan are to be followed with the exception of unexpected changes in health care needs. Patients in this program cannot have more services than what is outlined in their care plan; a guiding principle of the FMHC program is that there is equity between traditional home care and Family- Managed Home Care. z Funding covers the cost of care. z Ontario Health atHome establishes patient reporting requirements and payment schedules. z A legal agreement outlining responsibilities must be signed by the patient and/or their SDM, and Ontario Health atHome. z Ontario Health atHome will reassess the patient’s care needs regularly, as per the normal practice under traditional home care. z Patients or SDMs will continue to collaborate […]
Family Managed Home Care – Fact Sheet – English
[…] providers in the hom e, including establishing contingency plans. z Able to fully understand and carry out the responsibilities of being an employer, often of multiple care providers. z Capable of managing the fnancial aspects of the program, including the bank account, payment of care providers/agency and taxes, securing insurance, record-keeping and fulflling Ontario Health atHome’s reporting requirements. z Able to use a computer, spreadsheet, scanner, send and receive emails with attachments, name computer fles and enter billing and invoice information in the manner and method requested by Ontario Health atHome (e.g., can be by email or through an online portal). Other Information z The hours and services in the care plan are to be followed with the exception of unexpected changes in health care needs. Patients in this program cannot have more services than what is outlined in their care plan; a guiding principle of the FMHC program is that there is equity between traditional home care and Family- Managed Home Care. z Funding covers the cost of care. z Ontario Health atHome establishes patient reporting requirements and payment schedules. z A legal agreement outlining responsibilities must be signed by the patient and/or their SDM, and Ontario Health atHome. z Ontario Health atHome will reassess the patient’s care needs regularly, as per the normal practice under traditional home care. z Patients or SDMs will continue to collaborate […]
Quality-Framework-Summary-EN
[…] patient, family, and caregiver co-design to ensure that the patient voice is i ncorporated in everything we do. 5. Collaboration with Health System Partners – We are committed to the Health System Transformation agenda as active partners in the Ontario Health Teams across the province. 6. Integrated Care Processes & Best Practices – Services must be equitable, high quality, efcient, efective, based on best practices and integrated to promote a continuum of care and supp ort, local involvement, coordination, and cooperation. 7. Communication and Consistency in Care Team – Ontario Health atHome and Service Provider Organizations are committed to communicating efectively and consistently w ith patients and their families and caregivers. Quality Framework | 3 8. Culture of Continuous Quality Improvement – A culture of continuous improvement is foundational to the Quality Framework and results when an organization exemplifes the six dim ensions of quality, supported by the key enablers. 9. Data Excellence, Digital Enablers & Measuring Quality – One of our goals is to create an innovative, integrated, province-wide system that ensures equitable access, regard less of where a patient lives. Excellent quality data is essential to drive decision-making and the organizat ion’s accountability in achieving its aims. 10. Organizational Financial Health – Ontario Health atHome operates in a fnancially responsible manner to generate value and sustainability for the system and the patients we serv e. 11. Business Strategies, Policies, Procedures and Frameworks – The Board determines strategic priorities and directions for the organization which translate into operationa l priorities designed to achieve the Quadruple Aim. Frameworks, standards, policies, best practi ce guidelines, procedures, tools and templates help us to carry out those priorities which support consistent pra ctices and processes across the province. References […]
Quality-Framework-Summary-EN
[…] patient, family, and caregiver co-design to ensure that the patient voice is i ncorporated in everything we do. 5. Collaboration with Health System Partners – We are committed to the Health System Transformation agenda as active partners in the Ontario Health Teams across the province. 6. Integrated Care Processes & Best Practices – Services must be equitable, high quality, efcient, efective, based on best practices and integrated to promote a continuum of care and supp ort, local involvement, coordination, and cooperation. 7. Communication and Consistency in Care Team – Ontario Health atHome and Service Provider Organizations are committed to communicating efectively and consistently w ith patients and their families and caregivers. Quality Framework | 3 8. Culture of Continuous Quality Improvement – A culture of continuous improvement is foundational to the Quality Framework and results when an organization exemplifes the six dim ensions of quality, supported by the key enablers. 9. Data Excellence, Digital Enablers & Measuring Quality – One of our goals is to create an innovative, integrated, province-wide system that ensures equitable access, regard less of where a patient lives. Excellent quality data is essential to drive decision-making and the organizat ion’s accountability in achieving its aims. 10. Organizational Financial Health – Ontario Health atHome operates in a fnancially responsible manner to generate value and sustainability for the system and the patients we serv e. 11. Business Strategies, Policies, Procedures and Frameworks – The Board determines strategic priorities and directions for the organization which translate into operationa l priorities designed to achieve the Quadruple Aim. Frameworks, standards, policies, best practi ce guidelines, procedures, tools and templates help us to carry out those priorities which support consistent pra ctices and processes across the province. References […]
CH-LTCH-Short-Stay-Respite-Counselling-Checklist-EN
[…] Due to safety concerns in the LTCH, I am una ble to keep my medications in my room with me. Instead, during my stay, the LTCH will order and dispense my medications for me. I will be charged dispensing fees and must pay for medications not covered under the Ontario Drug Benefit program. […]
LTCH Short-Stay Respite Counselling Checklist for Community Patients – English
[…] Due to safety concerns in the LTCH, I am una ble to keep my medications in my room with me. Instead, during my stay, the LTCH will order and dispense my medications f or me. I will be charged dispensing fees and must pay for medications not covered under the O ntario D rug […]