2. Provincial Hospital Resource System Repatriation Tool Self – Directed Learning for LHIN Users 1 The PowerPoint presentation is intended to be Self – Directed Learning for LHIN Users. It will take approximately 15 minutes to view in “Slide Show” mode.

3. Overview of the Self – Directed Learning Slide Deck  Background & Purpose of the PHRS Repatriation Tool  Module 1: Access and Log in to PHRS  Module 2: Create to Repatriate the Request  Module 3: Re-direct the Request  Module 4: Responding to Confirmation Delay  Module 5: Responding to Repatriation Delay  Module 6: Cancel and Re-issue the Request  Summary & Contact Information 2

4.  Component of the Provincial Hospital Resource System (PHRS) to track, send, receive and monitor repatriation requests between tertiary/higher level care hospitals and acute care hospitals only  The repatriation tool excludes requests to:  Long Term Care Facilities  Rehabilitation Hospitals  The Repatriation Tool supports the Ministry of Health & Long Term Care Life or Limb Policy. The Life or Limb Policy is available at: http://www.health.gov.on.ca/en/pro/programs/criticalcare/life.aspx http://www.health.gov.on.ca/en/pro/programs/criticalcare/life.aspx 3 Purpose of the PHRS Repatriation Tool

5. Repatriation Tool Implementation April 2013 Neonatal Retrotransfer GTA (19 hospitals) June 2013 LHIN 13 July 2013 LHIN 4 November 2013 LHIN 14 April 2014 LHIN 7 LHIN 8 LHIN 9 LHIN 12 May 2014 and beyond LHIN 1 LHIN 2 LHIN 3 LHIN 5 LHIN 6 LHIN 10 LHIN 11 4

6. 5 5 Phases in the 2014 Repatriation Algorithm to show the JOURNEY of the Request from start ( create) to finish ( repatriate) Blue-sending hospital responsibility Green-receiving hospital responsibility

7. Requirements for PHRS Site Browser 6

8. Colored Font and Flags 7 Blue fontRepatriation requests from CritiCall Ontario for patients that have been sent out of province will appear in blue font Red fontRepatriation requests that are “Declined” or “Not Accepted” appear in red font Green font Repatriation requests that are “Repatriated” will appear in green font Appears for 24 hours next to “Active” requests Appears for 24 hours next to requests that have been modified Appears when the repatriation request becomes delayed two days after the Requested Transfer Date For Details on Definitions, go to PHRS Library Tab on https://www. phrs.criticall.org

9. Module 1 Access and Log in 8

10. Open a web browser. into the address bar. Get you username and password from your Hospital designated PHRS Registration Manager Go to https://www.phrs.criticall.org and type in your username and password and click on LOGINhttps://www.phrs.criticall.org Logging into the PHRS 9

11. PHRS Map View: Click on your LHIN LHIN Regions 10 Click on your LHIN

12. LHIN View: Click on the Repatriation Tab located on the Toolbar Navigation displayed depends on User’s access level 11 Click on the Repatriation Tab on the Toolbar

13. Module 2 Create to Repatriate 12

14. 13 Create Send Request

15. 14 2014 Repatriation Algorithm

16. Create: Select “My Hospital Site” then click “Add New Request” 15 Sending Hospital

17. Create: Step 1-Select Bed Type, Requested Transfer Date, Sending Specialty/service and Requested Hospitals 16 Click Next to go to Step 2 and click on CANCEL to go previous step

18. Create: Step 2-Enter the data in Health Card Number, Ward and Family Physician; Select the Gender, Age and Patient Home Hospital 17 Click Next to go to Step 3 and click on Back to go previous step Red arrow: Enter Data Yellow arrow: select from dropdown list

19. Create: Step 3- Add checkmark in the Initial Precaution Status and in the Initial Patient Medical Information then click on NEXT 18 Click Next to go to 4 and click on Back to go previous step Click on + to expand selection

20. Create: Step 4-Add Name and Phone number for Sending Physician and primary staff contact then Click on SAVE 19 Click SAVE when done or BACK to go to previous step

21. Create: View the Completed “New Active” Request 20 Sending Hospital

22. 21 Acknowledge ProceedDecline

23. 22 2014 Repatriation Algorithm

24. Acknowledge: View the New Active Request 23 Click on active request Receiving Hospital

25. Acknowledge: Select “Proceed” or “Decline” & Click SAVE 24 Receiving Hospital

26. Acknowledge: Select “Proceed” and Click SAVE 25 Receiving Hospital

27. Acknowledge: Add Contact Information & Click SAVE 26 Receiving Hospital

28. Acknowledge: Add Comments in Proceed Comments Box (optional) & Click SAVE 27 Proceed Comments are optional

29. Acknowledge: “ Proceed” status can be changed to “Decline” & Click SAVE 28 Receiving Hospital

30. Acknowledge: Select “ Reasons for Decline”& Click SAVE 29 Decline Comments are optional

31. 30 Confirm AcceptNot Accept

32. 31 2014 Repatriation Algorithm

33. Confirm: Select “ Accept” or “Not Accept” & Click SAVE 32 Receiving Hospital

34. Confirm: Add “ Accept” Comment Box (optional) & Click SAVE 33

35. Confirm: View “Accepted” Request 34 Receiving Hospital

36. Confirm: “Accept” can be changed to “Not Accept” & Click SAVE 35 Receiving Hospital

37. Confirm: Select “Reason for Not Accept & Click SAVE 36 Not Accept Comments are optional

38. Confirm: Click on the Not Accepted Request to View in the Not Accepted Tab 37 Receiving Hospital

39. Confirm: Click on Comments Tab to View Comments related to request 38 Sending Hospital

40. 39 Transport Transport Arranged Transport Scheduled

41. 40 2014 Repatriation Algorithm

42. 41 Transport: Click on Transport & Click on SAVE Sending Hospital

43. 42 Transport: Add DATES for Transport Arranged & Scheduled then Click on YES

44. 43 Repatriate Select Calendar Date

45. 44 2014 Repatriation Algorithm

46. Repatriate: Click on Repatriate & Click on SAVE 45 Sending Hospital

47. Repatriate: Add Date and Click on YES 46

48. Repatriate: View Repatriated Status Request in the Repatriated TAB 47 Sending Hospital

49. Module 3 Redirect the Request 48

50. 49 2014 PHRS Repatriation Algorithm –Redirect Sending Hospital can redirect the request when the receiving hospital has declined or not accepted up to the Transport Phase

51. Redirect: View Not Accepted Request 50 Sending Hospital

52. Redirect: View Redirect History and Click SAVE 51 Sending Hospital

53. Redirect: View Redirect History 52

54. Redirect: Click on Comments Tab to view comments 53

55. Re-direct: Click on Redirect request and click on SAVE 54 Sending Hospital

56. Redirect : Click on YES to Redirect 55

57. Redirect: Click on Add Hospital & on SAVE 56 Sending Hospital

58. Redirect: Select Hospital and Click YES 57

59. Redirect: View Redirect Request in Active /Redirect TAB 58 Sending Hospital

60. Redirect: View Redirect Request in Active/Redirect TAB 59 Receiving Hospital

61. Module 4 Responding to Confirmation Delay 60

62. When does Confirmation Delay occur? “ Confirmation Delay occurs when the Receiving Hospital responds in the Confirm phase two days after the Requested Transfer Date” For more details, go to the Definitions document available in the PHRS Library Tab on https://www.phrs.criticall.org https://www.phrs.criticall.org

63. Confirmation Delay: Click on Proceed Tab to respond to the delayed Proceed Request 62 Check in the flag column for the CLOCK icon indicating delay Receiving Hospital

64. Confirmation Delay: Select Reason for Confirmation Delay, Add Optional Comments & Click on Save 63 Add comments (optional )

65. Module 5 Responding to Repatriation Delay 64

66. When does a Repatriation Delay occur? “ Repatriation Delay occurs when the Sending Hospital responds two days after the Requested Transfer Date” For more details, go to the Definitions document available in the PHRS Library Tab on https://www.phrs.criticall.org https://www.phrs.criticall.org

67. Repatriation Delay : Add date & Select reasons for repatriation delay then click YES 66

68. 67 Repatriation Delay: Go to Comments Tab to review reasons for Repatriated Delay Sending Hospital

69. Module 6 Cancel & Re-issue Request 68

70. When does Cancel and Re-issue occur? “The Sending Hospital can cancel the request at any point in time if the repatriation is no longer required (e.g. patient deteriorates or is discharged). Cancelled requests will remain available for ‘Reissue’ for 7 days.” For more details, go to the Definitions document available in the PHRS Library Tab on https://www.phrs.criticall.org https://www.phrs.criticall.org

71. Cancel: View the Request to be Cancelled 70 Sending Hospital

72. Cancel: Click on Cancel Request & on SAVE 71 Sending Hospital

73. Cancel: Select Reason for Cancellation & Click on YES 72

74. Cancel: Go to Cancelled TAB to view Cancelled Request 73 Cancelled requests can be left as cancelled or re-issued within 7 days of the requested transfer date Sending Hospital

75. Re-issue: Click on Reissue Request 74 Sending Hospital

76. Re-issue: Click YES to proceed with reissuing request 75

77. Re-issue: Update Request details, Initial Precaution Status, Initial Medical Info and SAVE 76 Sending Hospital

78. Re-issue: Select Initial Medical Info and Click on YES 77

79. Re-issue: Select Initial Precaution Status and Click on YES 78

80. Re-issue: Click on Add Hospital & on SAVE 79 Sending Hospital

81. Reissue: Select Requested Hospital and Click YES 80

82. Re-issue: View Reissued Request in Active/Redirect TAB 81 Sending Hospital

83. Reissue: View Reissued Request in Active/Redirect TAB 82 Receiving Hospital

84. Summary & Contact Information 83

85. Sending Hospital Responsibilities  Create and send new repatriation requests to hospitals participating in the repatriation agreement  Monitor and update repatriation request as required for the following: Transport, Repatriate, Redirect or Cancel  Redirect requests not accommodated in accordance with Requested Transfer Date or ‘Not Accepted’ by the receiving hospital  Contact accepting hospital by telephone to confirm repatriation details  Update request status to “Transport” by Selecting Date of transport arranged and scheduled transport date  If the Repatriation Date is 2 days greater than the Requested Transfer Date, select the ‘Reason for Repatriation Delay’ from the dropdown menu 84

86. Receiving Hospital Responsibilities  Acknowledge all new or redirected repatriation requests received and indicating ‘Proceed’ or ‘Decline’  If ‘Decline’ is selected choose a ‘Reason for Decline’ from the dropdown menu  Contact sending hospital for physician- to-physician dialogue to exchange patient details  Confirm the repatriation request by indicating ‘Accept’ or ‘Not Accept’  If ‘Not Accept’ is selected choose a ‘Reason for Not Accept’ from the dropdown menu  Select a Reason for Confirmation Delay If the Not Accept Date is more than 2 days after the Requested Transfer Date or Redirect date 85

87. Training Support  The following training materials are available in the PHRS Library Tab on https://www.phrs.criticall.org :https://www.phrs.criticall.org  Repatriation Tool Quick Guide  Reasons for cancellation, decline, not accepted, confirmation and repatriation delays (drop down document)  Definitions  Algorithm 86

88. Contact Information  For CritiCall Ontario Repatriation Tool Training Questions contact your Client Relations Manager or email phrstraining@criticall.org phrstraining@criticall.org  For PHRS Repatriation Username & Password access, contact your hospital designated PHRS-Registration Manager  For technical assistance, first contact your hospital IT dept., if not resolved then contact PHRS help desk: phrshelpdesk@criticall.org phrshelpdesk@criticall.org 87

89. Client Relations Managers LHINs 1,2,3 Stephanie Piper 289- 396- 7000 X7581stephanie.piper@criticall.orgstephanie.piper@criticall.org LHINs 4,5,6 Leanne Yonev 289- 396- 7000 X7568leanne.yonev@criticall.orgleanne.yonev@criticall.org LHINs 7,8,& 12 Vanessa Alexis289- 396- 7000 X 7557vanessa.alexis@criticall.organessa.alexis@criticall.org LHINs 9,10, 11 Claudine Wathier - Doucet 613- 321- 0603claudine.wathier-doucet@criticall.orgclaudine.wathier-doucet@criticall.org LHIN 13 & 14 Liz Louden289-396-7000 X 7560liz.louden@criticall.orgliz.louden@criticall.org 88