On-Call + Resources

On-Call

Patient Care

Patient is Suicidal!

suicide-risk-assessment

Always document “CAIPS”

  • Chronic Factors
  • Acute Factors
  • Imminent Warning Signs
  • Protective Factors
  • Summary Statement

Safety Planning

PDFs

Patient Looks Unwell!

Neurological Emergencies

Internal Medicine Emergencies and Issues

Consider:

  • Withdrawal: Alcohol, GHB, opioids, other drugs
  • Bloodwork: consider CBC, electrolytes, BUN, creatinine, glucose, blood alcohol, urine drug screen. Always consider doing a beta hCG in females of reproductive age.
  • Investigations: consider CT head, ECG, or CXR

Patient is Agitated!

Pharmacological Management of Acute Behavioural Agitation

Patient Wants to Leave!

Emergency Capacity Assessment

Handouts and Information for Patients

Medications

Handouts, Worksheets and Workbooks for Various Mental Disorders

Therapy Handouts

Choosing Wisely Canada

Medical Education

It's Time to Review Case With Staff!

Legal and Reporting

What Needs To Be Reported?

See main article: CPSO Guidelines on Reporting

Reporting to an agency or organization can either be mandatory or permissive. Refer to the CPSO guidelines for full details.

Mandatory reporting situations:

  1. Child Abuse or Neglect
  2. Impaired Driving Ability
  3. Long-Term Care and Retirement Homes
  4. Sexual Abuse of a Patient (by Healthcare Provider)
  5. Facility Operators: Duty to Report Incapacity, Incompetence and Sexual Abuse
  6. Terminating or Restricting Employment
  7. Births, Still-births and Deaths
  8. Communicable and Reportable Diseases
  9. Controlled Drugs and Substances
  10. Community Treatment Plans
  11. Gunshot Wounds
  12. Pilots or Air Traffic Controllers
  13. Railway Safety
  14. Maritime Safety
  15. Occupational Health and Safety
  16. Correctional Facilities
  17. Preferential Access to Health Care

Should I Report My Patient's Driving?

Please refer to the OMA Recommendations on whether or not a patient needs to be reported.

In Ontario, the Highway Traffic Act requires that physicians report a patient, when they are of opinion that the individual has a medical condition or functional impairment that may make it dangerous for him or her to operate a motor vehicle. This act was most recently updated in 2018, and has new mandatory reporting situations.

Forms

Should I Report to a Children's Aid Society?

“Physicians who have reasonable grounds to suspect a child is in need of protection must report directly to a CAS, and not rely on any other person to report on their behalf.” – The College of Physicians and Surgeons of Ontario: Mandatory and Permissive Reporting

All circumstances of suspected child risk, abuse and neglect must be reported to appropriate child protection agencies at the time of assessment. If you are not sure whether reporting is necessary, you can call and discuss the situation without using the patient’s name. If child protective services advises that you must report, then identifying information must be given to them. There is someone available to receive your call 24 hours a day, 365 days a year.

Developmental Milestones

Should I Talk to Police About a Patient?

Hospital-specific

Centre for Addiction and Mental Health (CAMH)

CAMH On-Call (password-protected)

St. Michael's Hospital (SMH)

St. Michael's On-Call (password-protected)

Sunnybrook Hospital (SHSC)

Sunnybrook On-Call (password-protected)

</WRAP> </WRAP>

Greater Toronto Area Resources

Child, Youth, and Adolescent

Organizations

Counselling

Developmental Disorders

PDFs:

Adults/General

Referrals and Services

Geriatric

General

BPSD

Traumatic Brain Injury

Addictions

Drug and Alcohol Helpline

  • 1-800-565-8603

Referrals

Detox Beds

  • Toronto Central Detox Handout
  • Patients need to call Central Access at 1-866-366-9513 and complete a phone assessment to access a detox bed. If there are no detox beds available, the patient must continue to call Central Access every hour. There is no wait list for beds.

Gerstein Substance Use Crisis Team + Beds

  • 7 Short Term Residential Crisis Beds for up to 30 days is available through partnerships with University Health Network Ossington Withdrawal Management Centre (six beds for men) and Eva’s Satellite (1 bed for youth).
  • Individuals in crisis can access these services 24 hours/day through the crisis line at 416-929-5200 or can contact the team directly during business hours at 647-215-5386 (Daniel) or 647-637-2678 (Laura).

Eating Disorders

Anger Management

Transgender

Borderline Personality Disorder

See main article: Borderline Personality Disorder (BPD)

Crisis and Support Lines

Counselling + Psychotherapy

Shelters and Housing

Emergency Shelters

Housing/Shelter Central Access Intake

  • 416-338-4766
  • Dial 311: for shelter info and street outreach

CATCH Homeless Program

  • For homeless adults who are having trouble accessing medical services in the downtown area.
  • 416-864-5347
  • Referral Form

Streets to Homes Assessment and Referral Centre

  • 129 Peter Street (Mutual Contact Sheet)
  • If you are serving someone you learn or suspect is connected to either team, please use the Mutual Contact Sheet
  • These teams are within the circle of care for assessment, treatment and discharge planning
  • For assistance for individuals who may be living rough or on the street, please contact the Street Outreach Shift Leader, who is available 24/7 at 416-397-5182 or dial 311.
  • To refer to a shelter: 416-392-0090. Shelter Referral Access Point staff can assist by identifying where appropriate shelter beds are available.

Multi-Disciplinary Outreach Team (M-DOT)

  • Specialized team of providers from various organizations that delivers services to the most vulnerable individuals on the street and in shelters. The team helps their clients find housing, medical attention, income supports, or addictions services. (Mutual Contact Sheet)
  • During business hours (9am-5pm), contact the Program Manager, Mariruth Morton at 416-712-8221.
  • M-DOT can fax or deliver collateral information upon request.
  • After hours, messages can be left and will be returned the next morning (on weekends, calls will be returned the following Monday).
  • If immediate support is needed after hours or on weekends, ED staff can call the Streets to Homes Outreach Shift Leaders at 416-397-5182. The Streets to Homes Shift Leaders can send a team out (if available) to connect with the person. The Streets to Homes Shift Leaders will then communicate with MDOT on the next business day regarding any needed ongoing support.

OW, ODB, ODSP, EI, and Disability

Ontario Drug Benefit (ODB)

Ontario Disability Support Program (ODSP)

Ontario Works (OW)

CPP Disability Benefits

Employment Insurance (EI)

Primary Care

Apps + Websites

Cognitive Behavioural Therapy

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