Patient Education & Resources

Introduction to Integrated Vascular Management

Because almost all forms of acquired vascular disease have similar risk factors and management strategies, it is reasonable to consider that vascular management should be a major focus of the investigation and treatment strategy regardless of the first manifestation of vascular disease that brings a patient to attention.

All patients attached to the Integrated Vascular Management Clinic (IVMC) will have identical baseline information obtained and tracked. The additional elements of their care will be triggered by the presenting condition and the data that is acquired during the initial work up and investigation.

A referral to the IVMC will be considered a referral for the totality of vascular management. Each patient will have a "vascular physician" attached to their care. IVMC will make additional referrals as required to related specialties including: endocrinology, cardiology, vascular surgery, sleep medicine, nephrology, neurology, internal medicine and others.

TIA Clinic: Start Date: January 2006

Initially, patients will be referred to the TIA clinic via fax communication from Emergency Rooms. When the system is running smoothly and all participants are satisfied with the protocols and procedures, other sources of referral including family doctors and nurse practitioners will be added.

Initial telephone contact with the patient will be on the same day the referral is received. At that time the IVMC nurse will verify a history of likely TIA and verify that the patient is on anti-platelet or anticoagulation therapy. If not, that will be immediately reported to the vascular physician who will arrange for therapy.

TIA: "Acute Management"

• Holter Monitor
• Echocardiogram
• Carotid Doppler
• CT of head
• Book the neurology consult if this has not already been done

All of the above to be obtained in 2-3 working days from the time of referral to TIA Clinic. These data will then be presented to the consulting neurologist at the time of the first consultation.

TIA: "Chronic Management"

Following the initial consultation and care plan by the neurologist, the TIA Clinic will provide patients with ongoing vascular management both of a general nature and specific to the index condition. This will include but not be limited to:

• All of the vascular teaching modules as used in the cardiac rehabilitation programme (includes nutrition, cardiovascular emergencies, medications etc).
• Telephone or such other follow-up as determined by the neurology protocols.
• Coordination of a more broadly based vascular workup that would ordinarily include testing for cardiac ischemia and where indicated, vascular testing in other systems.

Communications:

All information and results gathered at TIA Clinic will be forwarded to the Family Physician or Nurse Practitioner as well as the neurologist and other specialists.

Note: The Vascular Health Network does not directly provide care to any patient. All patient care is the responsibility of the physicians involved. The Vascular Health Network provides some infrastructure support to the Integrated Vascular Management Clinic.