Referral Form

Please see Complex Medical Clinic Referral form for details. In general, the Referral Criteria includes:

  • Patients with multiple co-morbidities
  • ≥ 1 Inpatient hospitalization or ≥2 ED visits within last 6 months related to the chronic conditions
  • LACE score >5 (for discharge planners)

And the exclusion criteria includes: Chronic pain, cirrhosis, dialysis, transplant, severe dementia, and LTC residents.

Complex Medical Clinic

The Complex Medicine Clinic (CMC) is designed for adult patients with multiple chronic diseases who have been having frequent ED visits or hospitalizations.  Patients being referred are co-managed by an inter-disciplinary team consisting of:

  • Physician
  • Nurse practitioner
  • Pharmacist
  • Registered nurse (patient navigator)
  • Dietitian
  • Social worker
  • Kinesiologist

With a patient-centered approach, the goal is to reduce recurrent ED visits/hospitalizations through a coordinated transitional care delivery model. The team in collaboration with primary care providers and the patients’ specialists, will develop an integrated and sustainable care plan that will prevent unnecessary ED and inpatient visits related to their chronic disease.  

Location
Complex Medicine Clinic
Peel Memorial Centre for Integrated Health and Wellness
20 Lynch St. Brampton
Level 3, Zone C (purple area)

Tel: 905-863-2575 (internal ext 22575)
Fax: 905-863-2535 (internal fax 22535)

 

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