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Regional Hip and Knee Replacement Program

Regional Information Sheet

Consultation Instructions

Referral Form

Champlain LHIN Orthopaedic Surgeon Specialty List

Contact Us

August 2013

Dear Physician:

The Champlain LHIN’s Regional Hip and Knee Replacement Program has been operational since 2010. As of August 2013, there will be a change in process to streamline referrals and allow better access to care.

All referrals for patients who are potential candidates for primary total hip or total knee replacement MUST be sent to the regional central intake centre (CIC). Referrals sent to surgeons’ offices will be redirected to the CIC and the CIC will ask you to complete a new referral form. This process could take several months, so it would be best for your patient for you to complete the approved referral form and fax directly to the CIC.

Once processed at the CIC, referrals will be sent to either the Eastern Ottawa assessment centre located at Hôpital Montfort; the Cornwall Community Hospital; or, to the Western Ottawa assessment centre located at Queensway Carleton Hospital, with a satellite at the Pembroke Regional Hospital, based on patient geography. Services at all centres can be provided in English or French.

At the assessment centre, patients will have a 45 minute assessment by a specially trained nurse or physiotherapist who will outline their options. If surgery is not an option, the patient will be provided with conservative management advice and you will receive a letter outlining the plan of care. If surgery is an option, the patient will be informed of surgical wait times and will be allowed to choose a surgeon. They will then be scheduled to meet with their surgeon of choice in consult at any of the participating hospitals within the Champlain LHIN.

Please find attached our new referral form to be used immediately. More information can be obtained by calling the Regional Central Intake Centre at 613-721-7890 or by visiting our website at www.ChamplainRHKRP.com. Additional referral forms can be obtained through our website. Completed referral forms should be faxed to 613-721-7889.

Sincerely, Maureen Sly-Havey, RN, MSN

Project Lead, Regional Hip and Knee Replacement Program