How to transfer a child to Canuck Place

Canuck Place offers specialized palliative care for children and their families in BC and the Yukon. Canuck Place provides care both outpatient in the community as well as inpatient at our home-like environment settings in Vancouver or Abbotsford. Healthcare providers can a transfer to Canuck Place for a child in their care.

What is unique about a child transfer to Canuck Place?  

  • No on-site pharmacy or formula room
    • Medications/formulas are ordered from BCCH/BCW Ambulatory Care pharmacy or community pharmacies, so we require as much time as possible to accommodate medication orders.  
  • Home-like environment
    • Oxygen tanks and portable concentrators are used (no wall oxygen/air). Please discuss with Canuck Place if a patient requires greater than 9 litres per minute of oxygen.
    • Arterial lines cannot be supported. Additional lines and/or intensive care medications may not be appropriate in the care of the child at Canuck Place based on goals of care. 

Who is required to transfer a child to Canuck Place? 

For non-intubated, stable patients:  

  • The RN may accompany the child for transfer based on clinical need/complexity, on a case by case basis to provide direct handover to accepting RN. If RN accompanies transfer, a taxi voucher should be provided by the transferring hospital for the return to hospital.  
  • If the child is ready for discharge and the team determines appropriateness, then the parent/guardian can transfer the child in the car. 

For intubated or critical patients coming for compassionate withdrawal of life-sustaining treatment: 

  • The RN (and RT) accompanies the patient to provide direct handover to accepting RN. The RT will be expected to stay with the child until extubation, which could be 4-6 hours while the RN will return to the hospital within an hour of the admission. The transferring hospital should provide the RN and RT with separate taxi vouchers for their return to the hospital. 

What do I need to do as the transferring healthcare provider/hospital? 

Prior to transfer:  

  • Transferring hospital arranges the method of transport based on the needs of the child, teams/availability of transport, level of transport required and date/time to ensure a safe transportation plan (date and time of transport is confirmed with Canuck Place PRIOR to booking).
  • Canuck Place will collect relevant documents from the electronic chart when possible. When this is not possible requested documents will be outlined in the Transfer to Canuck Place checklist and a fax requested by the transferring hospital. Please be aware to share key details listed below in discussions to ensure transfer and care of child and family. 
    • This information is essential to prepare the child’s chart AND provide enough time for Canuck Place to order appropriate medications from BCCH Ambulatory Care pharmacy
    • If there are equipment/supplies pending, which are required prior to discharge then the transferring acute care hospital will provide the following information to Canuck Place:  
      • type of equipment ordered and date requested  
      • name of agency the equipment was ordered from  
      • ordering physician’s contact information  
      • expected delivery date of equipment and location of delivery (Canuck Place or home)  
      • AND loaner equipment if ordered equipment is not anticipated to arrive prior to discharge from Canuck Place (Please be aware when you order equipment from the At Home program, inquire about estimated time of arrival by contacting them directly)

Medications

  • If the child is assessed as “ready” for discharge home to the community but has requested a transfer to Canuck Place, the transferring acute care hospital will provide the family with FULL discharge prescriptions (with refills as indicated) for the family to use once discharged from CPCH.  
  • In the above mentioned case, Health Canada Special Access and/or PharmaCare Special Authority applications MUST be completed by the transferring acute care team and approved PRIOR to discharge/transfer from hospital. 
  • SEE DAY OF TRANSFER below for details regarding medications for transfer. o 

Formula/feeds

  • If the child has been prescribed a new formula during their hospital stay, the transferring hospital is responsible for ordering the formula from the At Home Program AND supplying the family/Canuck Place with a 24-48 hour supply of formula to arrive with the child on transfer (outlined in the Transfer Checklist). 
    • Canuck Place will purchase any additional formula beyond the 24-48 hours for a child awaiting their order from the AHP. 
  • If a child is on an established formula (i.e no changes were made in the hospital and the family can readily access the formula/feed for the stay), the family is responsible for supplying the formula.  
  • For formulas that are difficult to access in the community (i.e Liquid Hope), Canuck Place will request a larger quantity from BCCH Nutritional Services or request a way to access the formula or an alternative while the family waits. 

Day of Transfer

HANDOVER

  • Provide verbal nurse to nurse handover prior to transfer o Update CPCH team when the child is on their way (or expected time)  

MEDICATIONS/SUPPLIES

  • Ensure the child is transferred with all required equipment as outlined in the Transfer to Canuck Place Checklist (may include specified formula, medications, etc.) o Life-sustaining medications (e.g. inotropes, alprostadil) and medications required for comfort during transport will be provided by the acute care hospital on transfer. 
  • If the child is on the following medications, please provide an additional syringe with the transfer as a safety precaution (these medications should already be supplied to the child’s bedside at the hospital or accessed through the omnicell)  
    • Inotropes
    • Dexmedetomidine 
    • Alprostadil  

STAFF MEMBERS ACCOMPANYING THE TRANSFER

  • If the RN accompanies the transfer, expect to be at the hospice for a maximum of one hour to facilitate transfer of care and closing your therapeutic relationship.  
  • If the RT accompanies the transfer, expect to be at the hospice for 4-6 hours until compassionate extubation has occurred. If this time overlaps with lunch or dinner, Canuck Place will provide you with food.
Health Care Providers: Information to transfer a child to Canuck Place pdf 704.60 kb