Cardio-Obstetrics Patients - Sunnycare List & CritiCall

Sent on behalf of Dr. D MacLean - June 28, 2024

Hi everyone,

We now have a Sunnycare list which is being maintained by the cardiology department for current cardio-obstetrics patients. Since Sunnycare is no longer accepting requests for dedicated lists, our current stop-gap method is to disseminate the user's list who is maintaining it. Simply add this list to your favourites in Sunnycare and it should be readily accessible (see below for instructions). Please note, this list includes both antenatal patients as well as post-partum patient, who may be followed via this mechanism for up to 6 weeks. Please do not add or remove patients from this list.

We are working on a method to share additional patient details and care plans, similar to a sign-out list. I will provide an update if/when this happens. Please note that a recent improvement is that when shared case conferences happen, they will be pushed to Sunnycare from OBTV so these should also be accessible in one place. This applies to the non-cardiac complex OB patients as well.

Lastly, a reminder that when you are on M5 as the primary staff, it is your responsible review and sign any fellow consults as well as provide feedback. As we continue to see more cardio-obstetric consults, your role in reviewing and signing these consults will become more important.

Instructions for adding the cardio-obstetrics Sunnycare list:

1. Log into Sunnycare

2. At the top of the screen, click on drop-down menu "Select a Patient List"

   

3. Scroll to the bottom of this list

4. Click "View Other Lists". This opens a new box.

   

5. Under "Select a List", choose "User's List"

6. In the box below, type the list owner's name: "Derbakova, Anastasia". Two instances of this name will appear; choose the top name.

   

7. In the second box below the first, choose the list "Cardio-Obstetrics". This will allow to you review the current patients, which should appear.

   

8. To save your access to the list: again at the top of the screen, choose "List Options"

9. Click "Add to Favourites"

   

10. Once finished, the Cardio-Obstetrics Sunnycare list will now appear under the drop down "Select a Patient List" under the heading "My Favourite Lists"

    

11. Done

Please let me know if you have any questions.

Thanks,

David B. MacLean, BScH MSc MD FRCPC

Staff Anesthesiologist

Director of Obstetric Anesthesia

Department of Anesthesia

Sunnybrook Health Sciences Center

Department of Anesthesiology and Pain Medicine

University of Toronto

Issue With CritiCall - Dr. MacLean (July 12, 2024)

I’m emailing to address the potential issue of CritiCall transfers of high risk pregnant patients with cardiac comorbidities. This is in the context of a situation last night where there was a request for transfer to us via CritiCall of a pregnant patient not known to the Cardio-Obstetrics program at Sunnybrook. The obstetrician on-call appropriately declined this transfer; however, this will certainly come up again in the future as our program matures.

I have discussed this issue with nursing and obstetrics leadership already and wanted to ensure our group is on the same page as well. At this time, is it not appropriate to accept transfer of CritiCall patients with significant cardiac issues who are unknown to Sunnybrook. Alternative sites include Mount Sinai, London Health Sciences, or elsewhere.

We have not yet developed the expertise, capacity, or ability to care for these patients ad hoc. The only patients we should be seeing are those who have a previously established relationship with Sunnybrook and who have been seen and cleared via the Cardio-Obstetrics program. If you are working and become aware of one of these transfer requests, please discuss with the staff obstetrician on call to help determine appropriateness for transfer to Sunnybrook.

If you are a fellow or clinical associate working overnight or on weekends on obstetrics and encounter this issue (or any other issue you require advice on), please speak directly to the 1^st-call OR staff via 7878. We are here to support you with clinical decision making where needed.

As always, please bring any events or concerns to me.

Thank you very much,

Dave