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Policy #TitleRationaleDateSummaryLinkhf:doc_categorieshf:doc_tags
CLI.5910.PR.001.FORM.01Grief Snapshot Form | ARCHIVE NOTICEJan 19, 2026Document Search Searchpalliative-careclinical forms
CLI.5910.PR.001Grief Snapshot Procedure | ARCHIVE NOTICEJan 19, 2026palliative-careclinical
CLI.6310.SG.013.SD.02Information on Swallowing Difficulty with Stroke like Symptoms For Patients and their Families ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.SG.013.FORM.02TOR BSST Swallowing Monitoring Record ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical forms
CLI.6310.SG.013.FORM.01TOR BSST The Toronto Bedside Swallowing Screening Test ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical forms
CLI.6310.SG.013Toronto Bedside Swallowing Screening Test TOR-BSST ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.SG.013.SD.04Toronto Bedside Swallowing Screening Test TOR-BSST for Acute Stroke Patients Rehabilitation Services ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.FORM.02TOR BSST Swallowing Monitoring RecordJan 19, 2026rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.006.SD.07TOR BSST Task Sheet for Education FacilitatorJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.SD.06TOR BSST Task Sheet for SLP Assist Rehab AssistJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.SD.04TOR BSST Task Sheet for Speech Language PathologistJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.SD.05TOR BSST Task Sheet for Staff Development ClerkJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.FORM.01TOR BSST The Toronto Bedside Swallowing Screening TestJan 19, 2026rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.006.SD.03Toronto Bedside Swallowing Test Screening AlgorithmJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006.SD.02Information on Swallowing Difficulty with Stroke like Symptoms For Patients and their FamiliesJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.5910.PR.001.SD.01Bereavement Support to Caregivers Bilingual | ARCHIVE NOTICEJan 19, 2026palliative-careclinical
CLI.6310.PL.006.SD.01No Food Drink Or Medication By MouthJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.PL.006The Toronto Bedside Swallowing Screening Test Use for Acute Stroke PatientsJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.SG.013.SD.01No Food Drink Or Medication By Mouth ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.6310.SG.013.SD.03Quick Reference Guide for TOR BSST Swallowing Screeners ARCHIVE NOTICEJan 19, 2026rehabilitation-therapy-servicesclinical
CLI.4110.PL.003Safe Patient Handling ProgramJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.6310.PL.005.FORM.01Violence Prevention Plan Screening Tool and Individualized Care PlanJan 12, 2026rehabilitation-therapy-servicesclinical forms
CLI.4110.PL.003.SD.26Swift Ultra Slide Sheet Set How to PosterJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.03Theory SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.07Transfer and Mobility Assessment Form SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.15Transfer and Mobility AssessmentJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.14Transfer and Mobility Logos SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.27Transfer Belt How To PosterJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.09Transfer Belt UseJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.11Transfer Sling UseJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.16Transfers and Lifts AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.30Turning Disc Two Minimum Assist TransferJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.37Two Assist Mechanical Lift Using Hygiene SlingJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.38Two Assist Mechanical Lift using Pannus SlingJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.31Walking One or Two Minimum AssistJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.02Agreement with Participant SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.25Are You Ready 8 Principles of Good Body Mechanics PosterJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.20Bariatric Bed Mobility AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.21Bariatric Chair Repositioning AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.08Bariatric Risk Assessment ToolJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.19Bariatric Transfers and Lifts AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.17Bed Mobility AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.SG.014Provider ResponsivenessJan 12, 2026across-care-areasclinical
CLI.4510.PL.015.SD.03Seclusion Observation Record Directions for UseJan 12, 2026across-hospital-unitsclinical
CLI.4510.PL.015.SD.01Seclusion Room Checklist Quick Reference GuideJan 12, 2026across-hospital-unitsclinical
CLI.4510.PL.015.SD.02How to Conduct a Search Patient Entering a Seclusion RoomJan 12, 2026across-hospital-unitsclinical
CLI.4510.PL.015.FORM.01Seclusion Observation RecordJan 12, 2026across-hospital-unitsclinical forms
CLI.4510.PL.015Use of a Seclusion RoomJan 12, 2026across-hospital-unitsclinical
CLI.4110.PL.003.SD.22Equipment Ordering ResourceJan 12, 2026across-care-areasclient-teaching-handouts safe-patient-handling-sphp
CLI.4110.PL.003.SD.07Fixed Bed Use CommunityJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.02Introduction SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.36Lift with a Limb SlingJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.13Logos SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.34One Way Chair SliderJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.03Participant Record SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.12Performance Auditing SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
LI.4110.PL.003.FORM.05Performance Audit SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.04Poster SPHPJan 12, 2026across-care-areasclient-teaching-handouts safe-patient-handling-sphp
CLI.4110.PL.003.SD.06Preparation for Patient Handling TasksJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.35Repositioning in Bed with a Turning Sling Two Minimum AssistJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.33Repostioning in Bed One Minimum AssistJan 12, 2026across-care-areasclient-teaching-handouts safe-patient-handling-sphp
CLI.4110.PL.003.FORM.06Room Spot CheckJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.05Safe Work Area LayoutJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.32Seated Transfer Sit to Stand and Gait Training Device One Minimum AssistJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.01Sign in Form SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.4110.PL.003.SD.10Slider UseJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.29Sliding Board Transfer One Minimum AssistJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.24Stretches SPHPJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.5415.PL.004.SD.01After Hours Check In Check OutJan 12, 2026home-careclinical
CLI.4110.PL.003.SD.01SPHP Document and Link IndexJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.6410.SG.001.SD.01Congregate Meal Program Guidelines ARCHIVEDJan 12, 2026personal-care-homeclinical
CLI 6410 SG 001Congregate Meal Program ARCHIVEDJan 12, 2026personal-care-homeclinical
CLI.4110.PL.003.SD.18Chair Repositioning AlgorithmJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.23Consult for Sling Fitting and SizingJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.08Electric Bed UseJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.41Emergency Descent Down the Stairs with EVAC CHAIRJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.39Emergency Descent Downstairs with Evacuation SlydeJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.SD.40Emergency Lift Downstairs Using a Blanket or Canvas Evacuation ScoopJan 12, 2026across-care-areasclinical safe-patient-handling-sphp
CLI.4110.PL.003.FORM.04Employee Performance Outcome Measurement SPHPJan 12, 2026across-care-areasclinical forms safe-patient-handling-sphp
CLI.5415.PL.004Working in IsolationJan 12, 2026home-careclinical
CLI.5910.SG.006.SD.03Promoting High Quality Palliative CareTo outline the process for Palliative Care access for patients to Acute Care/Transitional care beds; either through ED or by prioritized admission.Jan 5, 2026palliative-careclinical
CLI.5910.SG.006.SD.02Palliative Care Process Map Admissions to Transitional Care or Acute CareTo outline the process for Palliative Care access for patients to Acute Care/Transitional care beds; either through ED or by prioritized admission.Jan 5, 2026palliative-careclinical
CLI.5910.SG.006.SD.01Palliative Care Patient Flowchart EDTo outline the process for Palliative Care access for patients to Acute Care/Transitional care beds; either through ED or by prioritized admission.Jan 5, 2026palliative-careclinical
CLI.4110.PL.025.FORM.01Conservative Sharp Wound Debridement Tracking RecordJan 5, 2026across-care-areasclinical forms
CLI.6310.FORM.004Inpatient Referral – Fillablemade form fillable added under the Occupational Therapy column - High falls risk as indicated by "Falls Risk Assessment and Interventions for Inpatients" toolJan 5, 2026rehabilitation-therapy-servicesclinical forms
CLI.4110.PL.022.FORM.04Ankle Brachial Pressure Index and Toe Brachial Pressure Index Tracking RecordJan 5, 2026across-care-areasclinical forms
CLI.4110.SG.003Skin Tear Treatment GuidelineJan 5, 2026across-care-areasclinical
CLI.4110.PL.025Conservative Sharp Wound DebridementJan 5, 2026across-care-areasclinical
CLI.5910.SG.006Palliative Care Patient Flow Regional Admission ProcessTo outline the process for Palliative Care access for patients to Acute Care/Transitional care beds; either through ED or by prioritized admission.Jan 5, 2026palliative-careclinical
ORG.1411.PL.502.SD.02Access Disclosure Release of Personal Health Information Fee ScheduleTo revise for new WCB rate effective January 1, 2025.Dec 29, 2025health-information-servicesorganizational privacy-and-access
CLI.8011.PL.011.FORM.01Post Exposure Protocol Follow Up ChecklistProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.4110.SG.004Take Home Naloxone Kit Distribution in CommunityDeveloped to standardize education and distribution processes of naloxone.Dec 22, 2025across-care-areasclinical
Provincial Nursing Agency Service Complaint FormDec 22, 2025human-resourcesforms
CLI.8011.PL.011Post Exposure to Blood and Body FluidsProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.4110.SG.004.SD.01Take Home Naloxone Kit Distribution in Community Training AcknowledgementDeveloped to standardize education and distribution processes of naloxone.Dec 22, 2025across-care-areasclinical
CLI.4110.SG.004.FORM.01Take Home Naloxone Kit Distribution Tracking FormDeveloped to standardize education and distribution processes of naloxone.Dec 22, 2025across-care-areasclinical forms
CLI.8011.PL.011.FORM.02PEP Needlestick injuries BBF Exposure Line ListProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.011.SD.01Post Exposure Protocol Quick Reference GuideProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.011.SD.02Template Letter to Exposed Healthcare ProviderProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.011.FORM.02PEP Needlestick injuries BBF Exposure Line ListProviding clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access.Dec 22, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
ORG.1010.PL.015Leader and Senior Leader Team On Callupdated regarding split weekDec 15, 2025administrationorganizational
TD1 Federal WorksheetDec 15, 2025human-resourcesforms payroll
TD1 MB WorksheetDec 15, 2025human-resourcesforms payroll
TD1 MBDec 15, 2025human-resourcesforms payroll
CLI.6611.PL.006Endoscopy Slating Elective and EmergencyDec 15, 2025perioperativeclinical surgical-unit-same-day-surgery
TD1 FederalDec 15, 2025human-resourcesforms payroll
ORG.1110.FORM.008Poster Templates IDec 8, 2025communicationsforms organizational
ORG.1110.PL.013.FORM.01Request for Speech Writing ARCHIVE NOTICEDec 4, 2025communicationsforms organizational
CLI.5110.PL.010.SD.01Shared Health Provincial SCU LevelsDec 1, 2025critical-care-er-observation-scuclinical
CLI.5110.PL.010.SD.03Special Care Unit Admission Criteria Boundary Trails Health CentreDec 1, 2025critical-care-er-observation-scuclinical
CLI.5110.PL.010.SD.02Special Care Unit Admission Criteria Portage Regional Health CentreDec 1, 2025critical-care-er-observation-scuclinical
CLI.5110.PL.010Special Care Unit AdmissionTo support effective utilization of the Special Care Units within Southern Health-Santé Sud (SH-SS). To define the level of care provided at each SCU within SH-SS. To describe and define the criteria and processes for patients who require admission.Dec 1, 2025critical-care-er-observation-scuclinical
CLI.6010.FORM.005Acute Adult PRN Medications Admission Standard Ordersminor wording changes to Nutrition & Food Services portionDec 1, 2025pharmacyclinical forms standard-order
ESP QHR Access Request FormNov 28, 2025human-resourcesforms payroll
Overtime FormNov 28, 2025human-resourcesforms payroll
ORG.1110.FORM.006Interior Door Signage Template for Bilingual StaffNov 24, 2025communicationsforms organizational
CLI.6310.PL.004.FORM.01Working Alone Safety Assessment Formreplaced CLI.6310.SG.015.FORM.01Nov 24, 2025rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.005Violence Prevention Plan Screening and Individualized Care PlanNov 24, 2025rehabilitation-therapy-servicesclinical
CLI.6310.PL.004Working Alone Safety Assessment RehabReplaced CLI.6310.SG.015Nov 24, 2025rehabilitation-therapy-servicesclinical
CLI.6310.SG.014.FORM.01Violence Prevention Plan Screening and Individualized Care Plan Rehab Services | ARCHIVE NOTICEReplaced with CLI.6310.PL.003.FORM.01Nov 24, 2025rehabilitation-therapy-servicesclinical forms
CLI.6310.SG.015.FORM.01Working Alone Safety Assessment Rehab Services | ARCHIVE NOTICENov 24, 2025rehabilitation-therapy-servicesclinical forms
CLI.6310.SG.014Rehab Services Violence Prevention Plan Screening and Individualized Care Plan | ARCHIVE NOTICEReplaced with CLI.6310.PL.003Nov 24, 2025rehabilitation-therapy-servicesclinical
CLI.6310.SG.015Rehab Services Working Alone Safety Assessment | ARCHIVE NOTICENov 24, 2025rehabilitation-therapy-servicesclinical
Employee Data Change RequestNov 19, 2025human-resourcesforms payroll
Bank Payout Correction Special Pay RequestNov 19, 2025human-resourcesforms payroll
ORG.1314.FORM.001Payroll Advice Form ARCHIVE NOTICENov 19, 2025finance human-resourcesforms
CLI.6611.FORM.001PreOperative Assessment Patient QuestionnaireNov 18, 2025perioperativeclinical forms surgical-unit-same-day-surgery
Nurses Recruitment and Retention Fund ApplicationNov 17, 2025forms
CLI.6611.PL.004Surgical Count and Prevention of Retained Surgical ItemsPreventing patient from risks associated with Retained Surgical Items such as sponges, needles, miscellaneous items and instruments. Preventing harm to staff due to items lost in garbage and linen. Preventing items from being lost from inventory.Nov 17, 2025perioperativeclinical surgical-unit-same-day-surgery
ORG.1510.PL.017Bereavement LeaveNov 17, 2025human-resourcesorganizational
Employee Status Change FormNov 10, 2025human-resourcesforms payroll
ORG.1110.PL.007Use of Southern Health-Santé Sud BrandingNov 4, 2025communicationsorganizational
ORG.1110.PL.012Social Media PublicNov 4, 2025communicationsorganizational
ORG.1110.PL.006Public Consultation and CommunicationNov 4, 2025communicationsorganizational
ORG.1110.PL.004Photography and Videography of Clients and Employees for any PurposesNov 4, 2025communicationsorganizational
ORG.1110.PL.002Graphic Standards and Corporate BrandingNov 4, 2025communicationsorganizational
ORG.1110.PL.013Events Planning CampaignsNov 4, 2025communicationsorganizational
ORG.1110.PL.001Elections and Political Access to Southern Health Santé Sud SitesNov 4, 2025communicationsorganizational
ORG.1110.PL.005Advertising Print and DigitalNov 4, 2025communicationsorganizational
CLI.6410.PL.002.FORM.11Integrated Care Plan Suicide Risk Assessment Audit FormNov 3, 2025personal-care-homeclinical forms
Sleep Disorder Centre Inpatient Referral Form FillableNov 3, 2025forms
Sleep Disorder Centre Inpatient Referral FormNov 3, 2025forms
CLI.4110.PL.005.FORM.01Supplemental Staffing Equipment and Supplies Transitional Care and PCH Request FormOct 27, 2025across-care-areasclinical forms
ORG.1310.FORM.001Employee Expense Claim Effective October 1 2025Oct 27, 2025financeforms organizational
CLI.4110.PL.005Supplemental Staffing Equipment and Supplies Transitional Care and Personal Care HomeOct 27, 2025across-care-areasclinical
CLI.4110.FORM.05Waiver of Responsibility and Liability BilingualOct 20, 2025across-care-areasclinical forms
CLI.4110.PL.013.SD.03Stroke Algorithm for Suspected Intracerebral Hemorrhage During and Post TNKOct 20, 2025across-care-areasclinical
CLI.5410.PL.007.SD.01.FClient Guidelines for Workplace Safety and Health-FROct 20, 2025home-careclinical
CLI.4110.PL.008Interim Placement of Alternate Level of Care PatientsAcute Care facilities in SH-SS will facilitate placement of ALC patients to optimize capacity. Facilitate the timely and most appropriate placement for person who no longer require Acute Care environments or who are paneled.Oct 20, 2025across-care-areasclinical
CLI.4110.PL.008.FORM.01Interim Placement for Patients Waiting For PCH Tracking Tool | ARCHIVE NOTICEReplaced with CLI.4110.PL.008.FORM.02Oct 20, 2025across-care-areasclinical forms
ORG.1810.PL.004Research Application and Approval ProcessTo establish the process for conducting an operational impact assessment on research applications submitted to Southern Health-Santé Sud, and to ensure research adheres to regulatory standards within our organizational framework.Oct 20, 2025quality-planning-and-performanceorganizational
CLI.5410.PL.007.FORM.01Working Alone Safety Assessment Safe Visit PlanOct 20, 2025home-careclinical forms
CLI.4110.PL.008.FORM.02Patient Transfer Tracking ToolAcute Care facilities in SH-SS will facilitate placement of ALC patients to optimize capacity. Facilitate the timely and most appropriate placement for person who no longer require Acute Care environments or who are paneled.Oct 20, 2025across-care-areasclinical forms
ORG.1810.PL.004.FORM.01.FApplication to Conduct Research French | ARCHIVE NOTICEOct 20, 2025quality-planning-and-performanceforms organizational
CLI.5410.PL.007.SD.03Working Alone Safety Assessment and Safe Visit Plan Nurse SchedulerOct 20, 2025home-careclinical job-aid
Handout Instructions Cast CareOct 20, 2025client-teaching-handouts
CLI.6410.PL.037.FORM.01Medical History and Physical Exam Form Personal Care HomeOct 20, 2025personal-care-homeclinical forms
CLI.6410.PL.037.SD.01Lab Investigations in Personal Care HomeOct 20, 2025personal-care-homeclinical
CLI.5410.PL.007.FORM.02Safe Visit PlanOct 20, 2025home-careclinical forms
CLI.6410.PL.037Medical Services in Personal Care Homes and Transitional CareOct 20, 2025personal-care-homeclinical
CLI.4110.PL.001.FORM.03Waiver of Responsibility (procedure, treatment or investigation) BilingualTo provide a standardized SH-SS form that combines all waivers of responsibility and liability relevant to inpatients.Oct 20, 2025across-care-areasclinical forms
Handout Instructions COPDOct 20, 2025client-teaching-handouts
CLI.4110.PL.008.FORM.01.FInformation for Patients Potential Transfer FRAcute Care facilities in SH-SS will facilitate placement of ALC patients to optimize capacity. Facilitate the timely and most appropriate placement for person who no longer require Acute Care environments or who are paneled.Oct 20, 2025across-care-areasclinical forms
ORG.1810.PL.004.FORM.01Application to Conduct Research | ARCHIVE NOTICEOct 20, 2025quality-planning-and-performanceforms organizational
CLI.4110.PL.008.FORM.03Alternate Level of Care Patient ProfileAcute Care facilities in SH-SS will facilitate placement of ALC patients to optimize capacity. Facilitate the timely and most appropriate placement for person who no longer require Acute Care environments or who are paneled.Oct 20, 2025across-care-areasclinical forms
ORG.1810.PL.004.FORM.0lResearch AgreementTo establish the process for conducting an operational impact assessment on research applications submitted to Southern Health-Santé Sud, and to ensure research adheres to regulatory standards within our organizational framework.Oct 20, 2025quality-planning-and-performanceforms organizational
CLI.4110.PL.001Consent for Procedures Treatment and InvestigationsOct 20, 2025across-care-areasclinical
CLI.5410.PL.007Working Alone Safety AssessmentOct 20, 2025home-careclinical
CLI.5410.PL.007.SD.02Working Alone Safety Assessment and Safe Visit Plan Resource Coordinator and Scheduling ClerkOct 20, 2025home-careclinical job-aid
CLI.4110.PL.008.FORM.01Information for Patients Potential TransferAcute Care facilities in SH-SS will facilitate placement of ALC patients to optimize capacity. Facilitate the timely and most appropriate placement for person who no longer require Acute Care environments or who are paneled.Oct 20, 2025across-care-areasclinical forms
CLI.6410.SG.002.SD.01Lab Investigations in Personal Care Home ARCHIVE NOTICEOct 20, 2025personal-care-homeclinical
CLI.5410.PL.007.SD.01Client Guidelines for Workplace Safety and HealthOct 20, 2025home-careclinical
CLI.6410.SG.002.FORM.01Medical History and Physical Exam Form Personal Care Home ARCHIVE NOTICEOct 20, 2025personal-care-homeclinical forms
CLI.6410.SG.002Medical Services in Personal Care Home ARCHIVE NOTICEOct 20, 2025personal-care-homeclinical
Home Care Treatment Clinic Billing FormOct 20, 2025finance home-careforms
ORG.1510.PL.013.FORM.01Performance and What Matters to You Conversation FormOct 15, 2025human-resourcesforms organizational
CLI.4110.PL.013.FORM.04Registration Clerk Notification Bethesda Regional Health CentreOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.FORM.05Registration Clerk Notification Boundary Trails Health CentreOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.FORM.06Registration Clerk Notification Portage Regional Health CentreOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.SD.04Management of Angioedema Caused by TNK use in Acute Ischemic StrokeOct 13, 2025across-care-areasclinical
CLI.6611.PL.004.FORM.01Operating Room Surgical Count All SitesPreventing patient from risks associated with Retained Surgical Items such as sponges, needles, miscellaneous items and instruments. Preventing harm to staff due to items lost in garbage and linen. Preventing items from being lost from inventory.Oct 13, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.4510.FORM.007Ambulatory Care Clinic Diabetic Foot Risk Assessment Triage ReferralTrialing the Referral Form used at BTHC and made electronically fillable.Oct 13, 2025across-hospital-unitsclinical forms
CLI.4110.PL.013.FORM.09National Institute of Health Stroke ScaleOct 13, 2025across-care-areasclinical forms
CLI.6310.FORM.005.FSouthern Childrens Therapy Network of Manitoba Referral Form FrenchOct 13, 2025rehabilitation-therapy-servicesclinical forms
CLI.4110.PL.013.FORM.11New Onset of Suspected Stroke Symptoms on Inpatient Units within a Stroke CentreOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.FORM.03Minor Stroke Transient Ischemic Attack TIA Risk Assessment and Standard OrdersOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.FORM.02Stroke Standard Orders No TNK 24 hours Post TNKOct 13, 2025across-care-areasclinical forms standard-order
CLI.4110.PL.013.SD.05Stroke care audit criteria stroke centres Emergency DepartmentsOct 13, 2025across-care-areasclinical
CLI.6611.PL.004.SD.01Management of Throat Packs During Surgical Procedure AlgorithmPreventing patient from risks associated with Retained Surgical Items such as sponges, needles, miscellaneous items and instruments. Preventing harm to staff due to items lost in garbage and linen. Preventing items from being lost from inventory.Oct 13, 2025perioperativeclinical surgical-unit-same-day-surgery
SC-INTRA005Sponge Needle and Instrument Count | ARCHIVE NOTICEOct 13, 2025across-hospital-unitsclinical
NS-1704.000Surgical Count Policy | ARCHIVE NOTICEOct 13, 2025across-hospital-unitsclinical
NS-E00.305Surgical Count Procedure List | ARCHIVE NOTICEOct 13, 2025across-hospital-unitsclinical
CLI.4110.PL.013.FORM.08Stroke Centres Emergency Standard Orders TranscribedOct 13, 2025across-care-areasclinical forms
CLI.6310.FORM.005Southern Childrens Therapy Network of Manitoba ReferralOct 13, 2025rehabilitation-therapy-servicesclinical forms
CLI.4510.FORM.005BTHC Orthopedic Referral FormOct 13, 2025across-hospital-unitsclinical forms
CLI.5110.PL.002.FORM.03Nurse Initiated X Ray Order ToolOct 13, 2025critical-care-er-observation-scuclinical forms
CLI.4110.PL.013.SD.06Stroke care audit non stroke centres Emergency DepartmentsOct 13, 2025across-care-areasclinical
CLI.4510.FORM.006Ambulatory Care Clinic Referral FormOct 13, 2025across-hospital-unitsclinical forms
CLI.6611.PL.004.SD.03Surgical Count Observational Audit CriteriaPreventing patient from risks associated with Retained Surgical Items such as sponges, needles, miscellaneous items and instruments. Preventing harm to staff due to items lost in garbage and linen. Preventing items from being lost from inventory.Oct 13, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.4110.PL.013Stroke CareBest Practice for stroke changes include changing the fibrinolytic to TNK instead of alteplase. Provincial direction to change the fibrinolytic. Stroke neurologists already ordering.Oct 13, 2025across-care-areasclinical
CLI.4110.PL.013.FORM.10Stroke Centres TNK Standard Orders First 24 hoursOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.FORM.07Stroke Centres Emergency Standard OrdersOct 13, 2025across-care-areasclinical forms
CLI.6611.PL.004.SD.02Perioperative Count ReferencePreventing patient from risks associated with Retained Surgical Items such as sponges, needles, miscellaneous items and instruments. Preventing harm to staff due to items lost in garbage and linen. Preventing items from being lost from inventory.Oct 13, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.4110.PL.013.FORM.01Acute Stroke Care Map for Emergency Departments at Non Stroke CentresOct 13, 2025across-care-areasclinical forms
CLI.4110.PL.013.SD.02Hyperacute Stroke Algorithm for Stroke CentresOct 13, 2025across-care-areasclinical
CLI.4110.PL.013.SD.03Role of Alteplase tPA in Stroke Care Information for Patients and Families Bilingual ARCHIVE NOTICEOct 13, 2025across-care-areasclinical
CLI.4110.PL.013.SD.01STROKE Transient Ischemic Attack TIA Algorithm for Responses in CommunityOct 13, 2025across-care-areasclinical
Functional Abilities FormOct 8, 2025human-resourcesability-management forms workplace-safety-and-health
CLI.5810.FORM.042Perinatal Triage Assessment ARCHIVE NOTICEOct 8, 2025obstetricsclinical forms
Employee Responsibilities While On LeaveOct 7, 2025human-resourcesability-management forms
Staff Safety Event Report SSEROct 7, 2025ability-management forms
CLI.5810.FORM.042Triage Fetal Health Surveillance Extension RecordThis document has now been combined with the Maternal Database, and the CLI number has been assigned to the Extension Record of the Combined Perinatal Triage Maternal Database formOct 6, 2025obstetricsclinical forms
MNU Additional Available Part Time and Casual Nursing ShiftsOct 6, 2025human-resourcesforms labour-relations
ORG.1411.PL.101.FORM.01.FRequest to Access Personal Health Information Form French PRINT ONLYOct 6, 2025health-information-servicesforms privacy-and-access
ORG.1411.PL.101.FORM.01Request to Access Personal Health Information Form PRINT ONLYOct 6, 2025health-information-servicesforms privacy-and-access
ORG.1411.PL.502.FORM.01.FConsent to Disclose French PRINT ONLYOct 6, 2025health-information-servicesforms privacy-and-access
ORG.1411.PL.502.FORM.01Consent to Disclose PRINT ONLYOct 6, 2025health-information-servicesforms privacy-and-access
Medical Action PlanOct 6, 2025human-resourcesability-management forms
CLI.5810.FORM.033Perinatal Triage Assessment – Maternal DatabaseOct 6, 2025obstetricsclinical forms
CLI.5910.SG.005.FORM.01Palliative Care Week On Call LogForm was revised to decrease the manual calculations and errors required by scheduling/payroll when nurses are on callOct 6, 2025palliative-careclinical forms
CLI.5110.PL.002Nurse Initiated Care in the Emergency Departmentupdated to reference RL Online Safety Event Reporting as well as X-Ray requirements for requesting orderOct 6, 2025critical-care-er-observation-scuclinical
CLI.6410.PL.014.FORM.03Fall Prevention and Management in PCH Environmental Fall Risk AuditOct 1, 2025personal-care-homeclinical forms
CLI.6410.PL.014.FORM.04Fall Prevention and Management in PCH Falls AuditHarmonization. Accreditation Canada Required Organizational Practice.Oct 1, 2025personal-care-homeclinical forms
Job Posting Request Restructures Sep 29, 2025human-resourcesforms
Handout Instructions Wound CareSep 17, 2025client-teaching-handouts
ORG.1510.PL.002.FORM.01Photo ID Request FormSep 15, 2025human-resourcesforms organizational
Advanced Glucose Monitors in the Home Care SettingSep 15, 2025home-careservice-delivery
New Employee Policies Sign Off Info Sheets ChecklistSep 13, 2025human-resourcesforms
Handout Instructions FeverSep 10, 2025client-teaching-handouts
Handout Instructions Viral RxSep 10, 2025client-teaching-handouts
CLI.6410.PL.038.SD.01Disaster Management Quick Reference Guide for Therapeutic Recreation OutingsSep 8, 2025personal-care-homeclinical
CLI.6410.PL.038.FORM.01Recreation Outing Department NotificationSep 8, 2025personal-care-homeclinical forms
CLI.6410.PL.038Therapeutic Recreation OutingSep 8, 2025personal-care-homeclinical
CLI.5110.PL.002.SD.01Accessing Health Care Services Emergency Department PosterSep 8, 2025critical-care-er-observation-scuclinical
CLI.5110.PL.002.FORM.02Emergency Department Pediatric Clinical Decision ToolSep 8, 2025critical-care-er-observation-scuclinical forms
CLI.5110.PL.002.FORM.01Emergency Department Adult Clinical Decision ToolSep 8, 2025critical-care-er-observation-scuclinical forms
CLI.5110.PL.002.FORM.04Emergency Department Adult Clinical Decision Tool MAR PRNSep 8, 2025critical-care-er-observation-scuclinical forms
CLI.5110.PL.002.FORM.05Emergency Department Pediatric Clinical Decision Tool MAR PRNSep 8, 2025critical-care-er-observation-scuclinical forms
CLI.6710.FORM.001.FSenior Social Prescribing Community Referral Form FRENCHSep 8, 2025seniors-services-communityclinical forms
CLI.6410.PL.027.FORM.03Regional Bathing Log Form Option 3Sep 2, 2025personal-care-homeclinical forms
Transfer And Mobility AssessmentSep 2, 2025human-resourcesforms
CLI.6410.PL.027Resident Choice and Safety During Baths or Alternative Bathing TechniquesDeveloped as a guide for PCHs on alternative bathing techniques and to provide bathing options.Sep 2, 2025personal-care-homeclinical
MNU FTSE Exception Application FormAug 29, 2025human-resourcesforms organizational
ORG.1912.PL.013Overtime Meal Claims VouchersThe overtime meal voucher needs to be updated from $10.00 to $12.00 for the MGEU staff due to ratification of MGEU contract. Added in a comment under the policy under important points to consider "as stated on the OT meal voucher form that is issued".Aug 18, 2025support-servicesfood-services organizational
ORG.1912.PL.013.FORM.01Overtime Meal VoucherThe overtime meal voucher needs to be updated from $10.00 to $12.00 for the MGEU staff due to ratification of MGEU contract. Added in a comment under the policy under important points to consider "as stated on the OT meal voucher form that is issued".Aug 18, 2025support-servicesfood-services forms organizational
CLI.8011.PL.024.SD.01.FMessage to Accompany Annual Resident Consent FrenchAug 18, 2025infection-prevention-and-controlclinical
CLI.8011.PL.024.SD.01Message to Accompany Annual Resident ConsentAug 18, 2025infection-prevention-and-controlclinical
CLI.4510.FORM.004Facility Home Care CommunicationAug 18, 2025across-hospital-unitsclinical forms
CLI.5510.SG.001.SD.01Contingency Plan Transportation of Equipment AlgorithmAug 18, 2025medical-device-reprocessingclinical
Adult Abuse Registry CheckAug 18, 2025forms
CLI.5510.SG.001Contingency Plan Transportation of EquipmentAug 18, 2025medical-device-reprocessingclinical
NS221-Appendix AFacility Home Care Communication Tool ARCHIVE NOTICEAug 18, 2025across-hospital-unitsclinical
CLI.4110.PL.033.SD.01Family Presence Policy PosterAug 18, 2025across-care-areasclinical
Child Abuse Registry CheckAug 18, 2025forms
Child Abuse Registry Check -FrenchAug 18, 2025forms
CLI.4110.PL.033Family PresenceAug 18, 2025across-care-areasclinical
CLI.6410.PL.013.FORM.01Resident Escort Information SheetUpdated to reflect the change to the PCH now contacting Virtual Emergency Care & Transfer Resource Service (VECTRS) instead of Medical Transportation Coordinator Centre (MTCC) when setting up an Inter Facility transfer. Additionally a spot has been added at the bottom of the form to track that the form has been forwarded to payroll and then on to finance for billing resident’s trust account.Aug 11, 2025personal-care-homeclinical forms
CLI.5610.PL.001.FORM.01.FReferral Form Adult FrenchAug 8, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.01Referral Form AdultAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.02Referral Form Child and AdolescentAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.02.FReferral Form Child and Adolescent FrenchAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.03Referral Form Crisis ServicesAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.03.FReferral Form Crisis Services FrenchAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.04Referral Form Seniors Consultation TeamAug 4, 2025mental-health-and-addictionsclinical forms
CLI.5610.PL.001.FORM.04.FReferral Form Seniors Consultation Team FrenchAug 4, 2025mental-health-and-addictionsclinical forms
ORG.1010.PL.005.FORM.01Document Development WorksheetConverted file to fillable PDFJul 28, 2025administrationforms organizational
ORG.1810.PL.006Recalls and Alerts ARCHIVE NOTICEJul 21, 2025quality-planning-and-performanceorganizational
ORG.1810.PL.006.SD.01Management of a Recall Alert Checklist for Equipment and or Product ARCHIVE NOTICEJul 21, 2025quality-planning-and-performanceorganizational
ORG.1810.PL.006.SD.03Management of a Recall Alert Checklist for Medication ARCHIVE NOTICEJul 21, 2025quality-planning-and-performanceorganizational
ORG.1810.PL.006.SD.02Management of a Recall Alert Checklist for Food ARCHIVE NOTICEJul 21, 2025quality-planning-and-performanceorganizational
CLI.6611.PL.003Surgical Slating Elective and EmergencyJul 14, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.003.FORM.01Surgical Slating ElectiveJul 14, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.003.FORM.02Surgical Slating EmergencyJul 14, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.003.SD.01Emergency Surgical Classification Procedure ListJul 14, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.4110.PL.029.FORM.07New Patient Admission Diet Information Nutrition Care Plan Regional CentresJul 14, 2025across-care-areasclinical forms
CLI.4110.PL.029Diet Orders Diet ChangesJul 14, 2025across-care-areasclinical
CLI.4110.PL.029.FORM.06Diet Change Form Portage Regional Health CentreJul 14, 2025across-care-areasclinical forms
CLI.4110.PL.029.FORM.05Diet Change Form Bethesda Regional Health CentreJul 14, 2025across-care-areasclinical forms
CLI.4110.PL.029.FORM.04Diet Change Form Boundary Trails Health CentreJul 14, 2025across-care-areasclinical forms
CLI.4110.PL.029.FORM.03Diet Change Form Acute Community HospitalsJul 14, 2025across-care-areasclinical forms
CLI.4110.PL.029.FORM.02New Patient Admission Diet Information Nutrition Care Plan Acute Community HospitalsJul 14, 2025across-care-areasclinical forms
CLI.8011.PL.008.FORM.02Occupational Health Immunization Intake FormJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.SD.02Occupational Safety and Health Standard OrdersJul 7, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.01Confidential Employee Immunization FormJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.07Staff Immunization Vaccine and Tuberculin OrderJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.03Occupational Health Immunization Review Summary FormJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008Occupational Health Immunizations for Health Care WorkersJul 7, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.04Occupational Safety and Health Employee Immunization Referral FormJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.06Positive Tuberculin Skin Test TST Physician Referral FormJul 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.4110.SG.002.FORM.01Braden Scale for Predicting Risk of Pressure InjuriesJul 7, 2025across-care-areasclinical forms
CLI.6410.PL.005Safe Feeding and Swallowing Program in Personal Care Home and Transitional CareJul 7, 2025personal-care-homeclinical
CLI.6410.PL.005.SD.02Obstructed Airway Abdominal Chest Thrust Training GuidelineJul 7, 2025personal-care-homeclinical
CLI.8011.PL.008.FORM.08Occupational Health Employee Intake FormJul 7, 2025infection-prevention-and-controlclinical forms
ORG.1311.FORM.004Miscellaneous Payment RequisitionJun 30, 2025financeaccounts-payable forms organizational
CLI.6611.SG.003Admission Criteria Same Day SurgeryJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.SG.003.FORM.01Pre Operative Record and Same Day Surgery ChecklistJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611. PL.005.SD.05Colonoscopy Discharge Instructions DirectionsJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.005.SD.04Gastroscopy Discharge Instructions DirectionsJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.005.SD.03Gastrointestinal Endoscopy Pre Procedure and Post Anesthesia Record DirectionsJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.005.SD.02Gastrointestinal Endoscopy Procedure Record DirectionsJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.005.SD.01Endoscopy Inadequate Prep Scheduling AlgorithmJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611 PL.005.FORM.04Colonoscopy Discharge Instructions FrenchJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611. PL.005.FORM.04Colonoscopy Discharge InstructionsJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611. PL.005.FORM.03Gastroscopy Discharge Instructions FrenchJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.005.SD.04Gastroscopy Discharge InstructionsJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.005.FORM.02Gastrointestinal Endoscopy Procedure RecordJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.005.FORM.01Gastrointestinal Endoscopy Pre Procedure and Post Anesthesia RecordJun 23, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.005EndoscopyJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.5510.PL.008.FORM 04Sterilizer RESULTS FormJun 23, 2025medical-device-reprocessingclinical forms
CLI.6611.PL.007Surgical Site Verification and MarkingJun 23, 2025perioperativeclinical surgical-unit-same-day-surgery
ORG.1810.PL.005.FORM.01Ethical Decision Making FrameworkJun 16, 2025quality-planning-and-performanceforms organizational
Provincial Account Request FormJun 16, 2025information-and-communication-technologyforms
ORG.1510.PL.014.FORM.01Request for Leave FormJun 16, 2025human-resourcesforms organizational
CLI.4110.SG.012.SD.03.FCompression Stockings FRJun 9, 2025across-care-areasclinical
CLI.4110.SG.012.SD.03Compression StockingsJun 9, 2025across-care-areasclinical
CLI.4110.SG.002.SD.05Taking the Pressure off Pressure Injury Prevention PamphletJun 9, 2025across-care-areasclinical
CLI.4110.SG.012.SD.02Managing Your Venous DiseaseJun 9, 2025across-care-areasclinical
CLI.4110.SG.012.SD.02.FManaging Your Venous Disease FRJun 9, 2025across-care-areasclinical
ORG.1912.PL.001Purchasing and Receiving FoodTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
ORG.1111.PL.004.FORM.01Translation Form BilingualJun 9, 2025french-language-servicesforms organizational
ORG.1912.PL.003Food Handling and PreparationTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
CLI.5410.PL.003Home Care Referral and Intake Process for Home Care ServicesJun 9, 2025home-careaccess clinical
CLI.5410.PL.003.FORM.05Home Care Referral Intake LogJun 9, 2025home-careaccess clinical forms
CLI.5410.PL.003.FORM.04Home Care Referral and Intake Process Home Care Treatment Clinic ReferralJun 9, 2025home-careaccess clinical forms
ORG.1912.PL.008Meals on Wheels ProgramTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
ORG.1912.PL.005Nutrition and Food Services Audit ProgramTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
ORG.1912.PR.001Routine Practices Handling Meal TraysTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
ORG.1912.PL.002Storage of Food Dry Goods and Chemical SuppliesTransferred existing documentation to the new template format without making any content revisions.Jun 9, 2025support-servicesfood-services organizational
CLI.4110.SG.012.SD.01Lower Leg Compression OptionsJun 9, 2025across-care-areasclinical
CLI.4110.SG.012.FORM.01Compression Treatment Standard OrdersJun 9, 2025across-care-areasclinical standard-order
CLI.4110.SG.012Lower Leg CompressionJun 9, 2025across-care-areasclinical
ORG.1912.PL.006.FORM.01Catering RequisitionStreamlined the catering requisition process by removing Option 1 – All-Day Meeting Expense – and enhancing overall workflow efficiency PDF FILLABLE FORMS: due to browsers defaults, you may experience issues viewing or filling out a fillable pdf form. Please download the file on your device prior to using.Jun 2, 2025support-servicesfood-services forms organizational
ORG.1511.PL.003.FORM.01Exit Interview SurveyJun 2, 2025human-resourcesforms organizational recruitment-and-retention
CLI.6110.FORM.008Dietitian Referral Form InpatientThe nutrition referral is used by health care providers to refer to the Clinical Dietitians when needed for acute care - inpatients. Typically it is used when another RD covers for them from another site. The form shall provide efficiencies for both the health care provider completing it and the RD when receiving it. The Regional Centres have been trialing this form for a couple of years. The small acute sites have a blank form that is not specific with this kind of information. It would be helpful for both nursing and RD's to use this regionally and will improve client care.Jun 2, 2025primary-health-careclinical forms
CLI.4110.SG.002.SD.10Skin Health Help Us Protect Your Skin and Prevent Pressure Injuries PamphletJun 2, 2025across-care-areasclinical
ORG.1511.PL.011Relocation AssistanceJun 2, 2025human-resourcesorganizational recruitment-and-retention
CLI.5414.SG.001Home Care Attendant Timekeeping Balance SheetJun 2, 2025home-careclinical forms resource-coordination
CLI.4510.PL.014.FORM.01Restraints Assessment Care Plan Tool Acute CareJun 2, 2025across-hospital-unitsclinical forms
CLI.5414.SG.001Storage of Home Care Attendant Timesheets Balance SheetsJun 2, 2025home-careclinical resource-coordination
Wildfire Support for Clinical StaffJun 2, 2025job-aid
ORG.1511.PL.009Employee RecognitionJun 2, 2025human-resourcesorganizational recruitment-and-retention
ORG.1510.SG.002Equivalecy of Nursing Students to work as a Health Care Aide GuidelineJun 2, 2025human-resourcesorganizational
ORG.1912.PL.006Catering Service and PricesMay 26, 2025support-servicesfood-services organizational
Reporting a Schedule of Planned ED Reduction of Standard Hours of OperationsMay 26, 2025job-aid
Measles Testing Recommendations Acute Care SitesMay 26, 2025job-aid
CLI.5810.FORM.072Standard Orders Fetal Stillbirthcorrected autopsy process according to Shared Health changesMay 26, 2025obstetricsclinical forms standard-order
CLI.6710.FORM.001Senior Social Prescribing Community Referral FormMay 19, 2025seniors-services-communityclinical forms
CLI.4110.SG.002.SD.04Reactive Support Surface Decision TreeMay 19, 2025across-care-areasclinical
CLI.4110.SG.002.SD.07How to Adjust Your ROHO CushionMay 19, 2025across-care-areasclinical
CLI.4110.SG.002Pressure Injury Prevention and TreatmentMay 19, 2025across-care-areasclinical
CLI.4110.SG.002.FORM.08InterdisciplinaryTeam Pressure Ulcer Safety Huddle FormMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.SD.02Support Surface Mattress Selection ToolMay 19, 2025across-care-areasclinical
CLI.4110.SG.002.FORM.09Turning and Positioning Flow SheetMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.SD.06Equipment for Offloading Friction and Shear PreventionMay 19, 2025across-care-areasclinical
CLI.4510.PL.014Restraints in Acute Care SettingMay 19, 2025across-hospital-unitsclinical
CLI.4110.SG.002.FORM.03Pressure Injury Prevention and Management Individualized Care Plan Home CareMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.FORM.02Pressure Injury Prevention and Management Intervention ChecklistMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.SD.08Pressure Injury Prevention Quick Reference GuideMay 19, 2025across-care-areasclinical
ORG.1513.PL.006Inclement Weather and WorkMay 19, 2025human-resourcesorganizational workplace-safety-and-health
CLI.4110.SG.002.SD.03Active Support Surface Decision TreeMay 19, 2025across-care-areasclinical
CLI.4110.SG.002.FORM.11Braden Scale Audit ToolMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.FORM.04Braden Scale Standard Care PlanMay 19, 2025across-care-areasclinical forms
ORG.1510.PL.013Performance EvaluationMay 19, 2025human-resourcesorganizational
ORG.1510.PL.018Code of Conduct PolicyMay 19, 2025human-resourcesorganizational
ORG.1513.PL.001Violence Prevention ProgramMay 19, 2025human-resourcesorganizational workplace-safety-and-health
ORG.1513.PL.003Workplace Safety Health CommitteesMay 19, 2025human-resourcesorganizational workplace-safety-and-health
CLI.4110.SG.002.FORM.05Health Care Aide Skin ObservationMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.FORM.06Home Care Attendant Skin ObservationMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.FORM.10Wound and Skin Discharge Summary FormMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.FORM.12Soaker Pad Audit ToolMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.SD.01Stage 2 3 4 and Unchangeable Pressure Injury Reporting Process AlgorithmMay 19, 2025across-care-areasclinical
CLI.4110.SG.002.FORM.07Braden Scale Standard Care Plan for PCHMay 19, 2025across-care-areasclinical forms
CLI.4110.SG.002.SD.09Pressure Injury Prevention Audit CriteriaMay 19, 2025across-care-areasclinical
ORG.1513.PL.001.SD.01Provincial Healthcare Violence Prevention Program Operational ProcedureMay 19, 2025human-resourcesorganizational workplace-safety-and-health
ORG.1513.PL.002Reasonable AccommodationMay 19, 2025human-resourcesability-management organizational workplace-safety-and-health
ORG.1513.PL.005Reporting and Investigating Serious WSH IncidentsMay 19, 2025human-resourcesorganizational workplace-safety-and-health
ORG.1510.PL.005Respectful WorkplaceMay 19, 2025human-resourcesorganizational
ORG.1513.PL.004Right to Refuse Dangerous WorkMay 19, 2025human-resourcesorganizational workplace-safety-and-health
ORG.1510.PL.010Conflict of InterestMay 19, 2025human-resourcesorganizational
ORG.1513.PL.007Workplace Safety and HealthMay 19, 2025human-resourcesorganizational workplace-safety-and-health
CLI.4510.PL.014.SD.01Restraints Assessment and Care Plan Tool Acute Care SampleMay 19, 2025across-hospital-unitsclinical
CLI.4510.PL.014.FORM.04Behavior Mapping Tool Acute CareMay 19, 2025across-hospital-unitsclinical forms
CLI.4510.PL.014.FORM.02Restraint Consent Form Acute CareMay 19, 2025across-hospital-unitsclinical forms
CLI.4510.PL.014.FORM.03Restraint Monitoring Record Acute CareMay 19, 2025across-hospital-unitsclinical forms
CLI.4510.PL.014.SD.06Restraint Audit Criteria Acute CareMay 19, 2025across-hospital-unitsclinical
CLI.4510.PL.014.SD.05.FRestraints Teaching Handout FRMay 19, 2025across-hospital-unitsclient-teaching-handouts clinical
CLI.4510.PL.014.SD.05Restraints Teaching HandoutMay 19, 2025across-hospital-unitsclient-teaching-handouts clinical
CLI.4510.PL.014.SD.04Behavior Mapping Tool Acute Care SampleMay 19, 2025across-hospital-unitsclinical
CLI.4510.PL.014.SD.03Restraint Monitoring Record Acute Care SampleMay 19, 2025across-hospital-unitsclinical
CLI.4510.PL.014.SD.02Restraints Consent Form Acute Care SampleMay 19, 2025across-hospital-unitsclinical
CLI.4110.PL.020.SD.01Notification of Letter of Delegation for the Public Guardian and Trustee of Manitoba ClientAdding language about next of kin as directed by MHSL (time sensitive). References updated.May 12, 2025across-care-areasclinical forms
CLI.4110.PL.020Public Guardian and Trustee of Manitoba CommiteeshipAdding language about next of kin as directed by MHSL (time sensitive). References updated.May 12, 2025across-care-areasclinical
CLI.4110.PL.014.SD.03Death in the Operating Roomupdated links as documents have been developedMay 12, 2025across-care-areasclinical
CLI.4110.PL.014.SD.02Tissue Bank Manitoba Sample Questions to Assess Donation Eligibilityupdated links as documents have been developedMay 12, 2025across-care-areasclinical forms
CLI.4110.PL.020.FORM.02Care Plan Annual Review for Clients of the Public Guardian and Trustee as CommitteeAdding language about next of kin as directed by MHSL (time sensitive). References updated.May 12, 2025across-care-areasclinical forms
CLI.6410.PL.004.FORM.06Personal Care Home and Transitional Care Unit Restaint Audit Summary ReportMay 12, 2025personal-care-homeclinical forms
CLI.6410.PL.004.FORM.05Personal Care Home and Transitional Care Unit Restraint AuditMay 12, 2025personal-care-homeclinical forms
After Hours Patient FlowMay 12, 2025job-aid
CLI.4110.PL.030Capacity Management ProtocolGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.May 12, 2025across-care-areasclinical
CLI.4110.PR.006Shrouding of DeceasedNo current guideline or direction exists for how and when to shroud deceasedMay 12, 2025across-care-areasclinical
CLI.4110.PR.008.FORM.01EDUC Operational Status Notification FormMay 12, 2025across-care-areasclinical forms
CLI.4110.PR.008Reporting Real Time Emergency Department ClosuresMay 12, 2025across-care-areasclinical
CLI.4110.PL.014Death in FacilityMay 12, 2025across-care-areasclinical
CLI.4110.PR.007Morgue Access and Release of DeceasedNo current guideline or direction exists for how to access the morgue and release of deceased at sites with a morgue. Morgue Status Board – new electronic initiative from Shared Health for HIS program.May 12, 2025across-care-areasclinical
IEN Academic AllowanceMay 12, 2025job-aid
CLI.4510.FORM.003Clinical Note TemplateChanged number due to archiving existing policy and renamedMay 5, 2025across-hospital-unitsclinical forms
CLI.6410.PL.005.FORM.03Safe Feeding and Swallowing Program in PCH and Transitional Care Audit SummaryMay 5, 2025personal-care-homeclinical forms
CLI.6410.PL.005.FORM.02Safe Feeding and Swallowing Program in PCH and Transitional Care Chart AuditMay 5, 2025personal-care-homeclinical forms
ORG.1810.PL.005Ethical Decision MakingMay 5, 2025quality-planning-and-performanceorganizational
Expense Claim MNU 2025-26May 5, 2025forms
ORG.1810.PL.005.SD.01Ethical Decision Making PosterMay 5, 2025quality-planning-and-performanceorganizational
ORG.1010.PL.005.SD.01Policy Procedure Standard Guideline Supporting Document and Forms Development and Approval ManualApr 28, 2025administrationorganizational
ORG.1010.PL.005Policy Procedure Standard Guideline Supporting Document and Forms Development and Approval ProcessTemplates changed to meet the Accessibility Standards.Apr 28, 2025administrationorganizational
ORG.1010.PL.005.FORM.03Procedure TemplateTemplate changed to meet Accessibility StandardsApr 28, 2025administrationforms organizational
ORG.1010.PL.005.FORM.04Standard Guideline TemplateTemplates changed to meet Accessibility StandardsApr 28, 2025administrationforms organizational
ORG.1010.PL.005.FORM.02Policy TemplateTemplates changed to meet Accessibility StandardsApr 28, 2025administrationforms organizational
Quality Service Award Nomination FormApr 24, 2025human-resourcesforms
Cultural Resource Toolkit ChecklistApr 22, 2025forms
CLI.4510.PR.002Chart Forms Acute CareApr 14, 2025across-hospital-unitsclinical
CLI.4110.SG.009Take 5Updated format to meet accessibility standards, create and include poster and form for use in clinical areas.Apr 14, 2025across-care-areasclinical
CLI.4110.SG.009.FORM.01Take 5 FormApr 14, 2025across-care-areasclinical forms
CLI.4110.SG.009.SD.01Take 5 PosterApr 14, 2025across-care-areasclinical
CLI.4510.PR.002.SD.15Adult Nursing Admission History DirectionsApr 14, 2025across-hospital-unitsclinical
CLI.5910.PL.008.FORM.01Advance Care Planning Goals Of Care Formformatting changes to signature linesApr 14, 2025palliative-careclinical forms
ORG.1810.PL.005.FORM.02Tracking Ethical Dilemma Discussion FormApr 14, 2025quality-planning-and-performanceforms organizational
CLI.4510.PR.002.FORM.24Adult Nursing Admission HistoryApr 14, 2025across-hospital-unitsclinical forms
ORG.1210.PL.003.FORM.01Disaster Management Exercise Debrief and TrackerApr 7, 2025disaster-managementforms organizational
CLI.4110.PL.014.SD.05Spiritual, Religious and or Cultural ConsiderationsApr 7, 2025across-care-areasclinical
CLI.4110.PL.014.FORM.01Notification of DeathApr 7, 2025across-care-areasclinical forms
CLI.5510.PL.011.SD.01A Point of Use Cleaning at Ward LevelApr 7, 2025medical-device-reprocessingclinical
CLI.5110.PL.011Point of Use Cleaning on UnitsApr 7, 2025medical-device-reprocessingclinical
Westman Lab Pathology Services Laboratory RequisitionApr 7, 2025across-care-areasforms
CLI.4110.PL.014.FORM.02.FConsent for Autopsy FrenchApr 7, 2025across-care-areasclinical forms
CLI.4110.PL.014.FORM.04Manitoba Justice Office of the Chief Medical Examiner Personal Care Home Death Report FormApr 7, 2025across-care-areasclinical forms
St. Boniface Pathology Services Laboratory RequisitionApr 7, 2025across-care-areasforms
ORG.1210.PL.003Emergency Preparedness Exercises Education TrainingApr 7, 2025disaster-managementorganizational
Authorization for Release Pathology SpecimensApr 7, 2025across-care-areasforms
ORG.1410.PL.001.FORM.03Client Chart Health Record Order Audit Tool PCH and Transitional Care CentresApr 7, 2025health-information-servicesforms health-information organizational
Handling of Remains in Perinatal LossApr 7, 2025across-care-areasforms
CLI.5910.PL.008Advance Care Planning Goals of Care PolicyAdded language about next of kinApr 7, 2025palliative-careclinical
CLI.4110.PL.014.SD.04Vital Statistics Manitoba Forms Requisition – FillableApr 7, 2025across-care-areasclinical forms
Pathology Specimen ReleaseApr 7, 2025across-care-areasforms
CLI.4110.PL.014.FORM.03Necropsy Clinical DataApr 7, 2025across-care-areasclinical forms
Pathology Services Request for Placental ExaminationApr 7, 2025across-care-areasforms
Authorization for Release of Tissue or Remains for Perinatal LossApr 7, 2025across-care-areasforms
CLI.5910.PL.008.SD.01Advance Care Planning Sharing Your WishesAdded language about next of kinApr 7, 2025palliative-careclinical
CLI.4110.PL.014.FORM.02Consent for AutopsyApr 7, 2025across-care-areasclinical forms
CLI.4110.PL.014.SD.01Death Documentation Package Checklist of FormsApr 7, 2025across-care-areasclinical
ORG.1210.PL.001.SD.01Site Leadership Disaster Management ResponsibilitiesApr 7, 2025disaster-managementorganizational
ORG.1210.PL.001.FORM.01Disaster Management After Action ReportApr 7, 2025disaster-managementforms organizational
ORG.1210.PL.004.SD.01Instructions for Employee Opt In for Additional Alerts | RAVEApr 7, 2025disaster-managementorganizational
ORG.1210.PL.001Emergency PreparednessApr 7, 2025disaster-managementorganizational
ORG.1210.PL.004Emergency Preparedness Use of Mass Notification AlertsApr 7, 2025disaster-managementorganizational
CLI.6611.PL.001Humidity Management PerioperativeMar 31, 2025perioperativeclinical surgical-unit-same-day-surgery
CLI.6611.PL.001.FORM.01Humidity RecordMar 31, 2025perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.001.FORM.02Medical Device Reprocessing Humidity RecordMar 31, 2025perioperativeclinical forms
CLI.5410.PL.004Eligibility for Home CareMar 31, 2025home-careaccess clinical
Disaster Mock or Full Scale Exercises Debrief | DASHBOARDMar 31, 2025disaster-management
ORG.1310.FORM.001Employee Expense Claim Effective February 16 2025Mar 24, 2025financeforms organizational
CLI.4110.PL.031.SD.06Bed Rail Safety Risk Assessment Toolminor formatting changesMar 24, 2025across-care-areasclinical
CLI.4510.PR.002.FORM.10Medication Administration Record MAR PRNMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.10Medication Administration Record MAR PRN DirectionsMar 17, 2025across-hospital-unitsclinical
CLI.4510.PR.002.SD.08Medication Administration Record MAR STAT and Non Recurring Medications DirectionsTo support implementation of new provincial high alert medication listMar 17, 2025across-hospital-unitsclinical
CLI.4510.PR.002.FORM.08Medication Administration Record MAR STAT and Non Recurring MedicationsMar 17, 2025across-hospital-unitsclinical forms
CLI.6410.PL.002.FORM.01.FPre admission Admission History Form FRMar 17, 2025personal-care-homeclinical forms
CLI.4110.PL.015.FORM.23Pharmacy Notification Form for cMAR Discrepancy or ChangeMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.SD..14Medication Administration Record Scheduled Patch Application and Removal DirectionsMar 17, 2025across-hospital-unitsclinical
CLI.4110.PL.015Safe Medication AdministrationAdding content for computer-generated Medication Administration Record (cMAR) related to regional implementation as well as Pharmacy related accreditation updates.Mar 17, 2025across-care-areasclinical
CLI.6010.SG.004.FORM.03Heparin Infusion FlowsheetMar 17, 2025pharmacyclinical forms
CLI.4510.PR.002.FORM.21Medication Administration Record MAR STAT and Non Recurrent portrait cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.20Medication Administration Record MAR STAT and Non Recurrent landscape cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.14Medication Administration Record MAR PRN 7 Day cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.09Medication Administration Record Scheduled DirectionsTo support implementation of the new provincial high alert medication listMar 17, 2025across-hospital-unitsclinical
CLI.4510.PR.002.FORM.09Medication Administration Record ScheduledMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.18Medication Administration Record MAR PRN Monthly cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.17Medication Administration Record MAR Scheduled 24 hour cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.16Medication Administration Record MAR PRN 24 hour cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.15Medication Administration Record MAR Scheduled 7 Day cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.19Medication Administration Record MAR Scheduled Monthly cMARMar 17, 2025across-hospital-unitsclinical forms
CLI.4110.PL.015.FORM.22Continuous Intravenous IV Infusion FlowsheetMar 17, 2025across-hospital-unitsclinical forms
CLI.6410.PL.002Integrated Care Plan for Personal Care Homes and Transitional CareMar 17, 2025personal-care-homeclinical
CLI.5110.PL.009Use of Pediatric TREKK GuidelinesTo outline the use of TREKK to provide standardized, evidence-based guidelines for pediatric patients that present to Emergency Departments throughout Southern Health-Santé Sud.Mar 10, 2025critical-care-er-observation-scuclinical
CLI.4510.SG.008Pulmonary Embolism Response Teamprovide guidance, information and a standardized process for health care professionals in emergency departments (ED) and inpatient units to identify and manage patients with Intermediate Risk (sub-massive) or High Risk (massive) Pulmonary Embolism (PE) and consulting of Pulmonary Embolism Response Team (PERT).Mar 10, 2025across-care-areasclinical
CLI.6010.PL.011Medication Order Writing and ProcessingMar 3, 2025pharmacyclinical
CLI.8011.PL.024Respiratory Virus Season Planning and Response in Personal Care HomesMar 3, 2025infection-prevention-and-controlclinical
CLI.6310.PL.002Rehabilitation Services Referral Process for Personal Care HomesMar 3, 2025rehabilitation-therapy-servicesclinical
CLI.6310.PL.002.FORM.01Rehabilitation Services PCH Referral FormMar 3, 2025rehabilitation-therapy-servicesclinical forms
CLI.8011.PL.024.FORM.01COVID 19 Influenza Pneumococcal and RSV Immunization Consent FormMar 3, 2025infection-prevention-and-controlclinical forms
CLI.8011.PL.024.FORM.01.FCOVID 19 Influenza Pneumococcal and RSV Immunization Consent Form FrenchMar 3, 2025infection-prevention-and-controlclinical forms
Medical Assessment for LTC FormMar 3, 2025home-carecase-coordination clinical forms
CLI.6310.PL.002.FORM.06Rehabilitation Services SLP Assessment Information ScriptMar 3, 2025rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.002.FORM.05Rehabilitation Services OT PT Assessment Information ScriptMar 3, 2025rehabilitation-therapy-servicesclinical forms
ORG.1410.PL.202.SD.01Retention Schedule for Non Client Recordsto reflect changes in The Limitations ActFeb 24, 2025health-information-serviceshealth-information organizational
ORG.1410.PL.303.FORM.01Notice of Lost Destroyed Incomplete Information FormFeb 24, 2025health-information-serviceshealth-information organizational
ORG.1410.PL.202Retention of Non Client RecordsFeb 24, 2025health-information-servicesorganizational
CLI.6410.PL.002.FORM.03Integrated Care Plan FormFeb 24, 2025personal-care-homeclinical forms
ORG.1410.PL.202.SD.02Change History Table Retention Schedule for Non Client Recordsto track revisions and whyFeb 24, 2025health-information-servicesorganizational
MNU Full Time Hours Salary Enhancement Part Time Nurse Identification FormFeb 19, 2025human-resourcesforms labour-relations
CLI.4110.PL.027Ultrasound Guided Peripheral Intravenous Insertionupdated list of referencesFeb 17, 2025across-care-areasclinical
CLI.6210.PL.003Immunization Management of School Class ListsDocument had minor changes and reflects the updated terms for the immunization program PHIMS which was previously Panorama and new templateFeb 17, 2025public-health-healthy-livingclinical
CLI.6210.PL.005Immunization Provision of Immunization Recordminor wording revisions and new templateFeb 17, 2025public-health-healthy-livingclinical
CLI.6010.SG.002Adult Gentamicin Tobramycin Monitoring and DosingFeb 17, 2025pharmacyclinical
CLI.8011.SG.004Occupational Health Infectious Disease and Upper Extremity Supportive Device Work RestrictionsFeb 10, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6410.SG.004.SD.01Oral Nutrition Supplement ONS Program Implementation Checklist Personal Care HomeFeb 10, 2025personal-care-homeclinical
CLI.6410.SG.004.SD.02Oral Nutrition Supplement ONS Program Education Handout Personal Care HomeFeb 10, 2025personal-care-homeclinical
CLI.6410.SG.004Oral Nutrition Supplement ONS Program Personal Care HomeTo support implementation of a supplement program in PCH's and to reference the implementation checklist and education handout as needed.Feb 10, 2025personal-care-homeclinical
CLI.5410.PL.005.SD.01Home Care Smoking Cannabis for Medical PurposesFeb 10, 2025home-careaccess clinical forms
CLI.5410.PL.006.SD.01Home Care Smoking Vaping Cigarette Cigar and eCigarette – BilingualFeb 10, 2025home-careaccess clinical forms
CLI.6410.PL.034.FORM.01Informed Consent Form for Use of Non Child Resistant Medication PackagingFeb 10, 2025personal-care-homeclinical forms
CLI.6410.PL.034Resident Leave of AbsencesFeb 10, 2025personal-care-homeclinical
ORG.1810.PL.010.SD.10Mandatory Reporting PosterFeb 10, 2025quality-planning-and-performanceorganizational
CLI.8011.SG.004.SD.01Illness Restrictions Precaution TableFeb 10, 2025infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.004.FORM.02Outbreak ReportFeb 7, 2025infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.6410.PL.002.SD.02Goals of Care Resource GuideFeb 4, 2025personal-care-homeclinical
CLI.6410.PL.002.FORM.09Interdisciplinary Quarterly Care Plan and Restraints ReviewFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.07Nutrition Assessment FormFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.01Pre admission Admission History FormFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.05Delivery of Care RecordFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.06Current System AssessmentFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.SD.01Completion of Integrated Care Plan Reference GuideFeb 4, 2025personal-care-homeclinical
CLI.6410.PL.002.FORM.04Clinical Record FormFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.08Therapeutic Recreaton Activity AssessmentFeb 4, 2025personal-care-homeclinical forms
CLI.4110.PL.009.FORM.01Subcut Line Identification StickerFeb 4, 2025across-care-areasclinical forms
CLI.4110.PL.009Subcutaneous Insertion Removal Medication Preparation Administration and Fluid AdministrationPolicy was due for updating and to conform to the accessibility standard.Feb 4, 2025across-care-areasclinical
CLI.6410.PL.002.FORM.10Integrated Care Plan Review FormFeb 4, 2025personal-care-homeclinical forms
CLI.6410.PL.002.FORM.02Resident Contact Information FormFeb 4, 2025personal-care-homeclinical forms
CLI.4110.PL.009.SD.02Giving medicines using a Subcutaneous ButterflyFeb 4, 2025across-care-areasclinical
CLI.4110.PL.009.SD.01How to Insert a Subcutaneous LineFeb 4, 2025across-care-areasclinical
CLI.6010.PL.048.FORM.01Total Parenteral Nutrition Standard OrdersUpdated standard orders to reflect the following changes: updated form number for Subcutaneous Insulin Correction Standard Order form number; updated section on CVADFeb 4, 2025pharmacyclinical forms standard-order
CLI.6010.PL.048Adult Total Parenteral Nutrition through a Central Venous Access Device: Administration and MaintenanceFeb 4, 2025pharmacyclinical
CLI.5413.SG.001.FORM.03Re Assessment Form for Long Term Care ApplicantsJan 31, 2025home-carecase-coordination clinical forms
CLI.5413.SG.001Assessment and Application Process for Personal Care Home Supportive Housing and Chronic CareJan 31, 2025home-carecase-coordination clinical
CLI.5810.PL.003Body Mass Index in PregnancyJan 31, 2025obstetricsclinical
CLI.6410.PL.036Managing Spitting as a Behavioural and Psychological symptom of DementiaJan 31, 2025personal-care-homeclinical
CLI.5810.SG.002.FORM.01Fetal Health Surveillance Audit – HospitalsJan 31, 2025obstetricsclinical forms
CLI.5510.PL.008.SD.01Sterilization Failure AlgorithmJan 31, 2025medical-device-reprocessingclinical
CLI.5510.PL.008.FORM.08MDR Daily and Weekly ChecklistJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.07Regional MDR Recall of Goods and Tracking FormJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.06Equipment Maintenance ReportJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.05Ultrasonic Daily Testing FormJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.03Inventory of Reusable Medical Devices for SterilizingJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.02Manual Instrument Tracking SystemJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.008.FORM.01BTHC Manual Instrument Tracking SystemJan 31, 2025medical-device-reprocessingclinical forms
CLI.5510.PL.005Sterilization Process Failures and RecallsJan 31, 2025medical-device-reprocessingclinical
CLI.5510.PL.008Reprocessing of Reusable Medical DevicesJan 31, 2025medical-device-reprocessingclinical
CLI.5413.FORM.001.FGuidelines for Private Seniors Living Residences FRJan 24, 2025home-careclinical forms
CLI.5413.FORM.002Private Seniors Living Residences FAQsJan 24, 2025home-careclinical forms
CLI.5413.FORM.002.FPrivate Seniors Living Residences FAQs FRJan 24, 2025home-careclinical forms
CLI.5413.FORM.001Guidelines for Private Seniors Living ResidencesJan 24, 2025home-careclinical forms
CLI.6410.PL.004Restraints in Personal Care Homes and Transitional Care UnitsJan 24, 2025personal-care-homeclinical
CLI.5810.FORM.017Birthing WishesJan 24, 2025obstetricsclinical forms
CLI.6410.PL.004.FORM.07Personal Care Home and Transitional Care Unit Emergency Restraint Monitoring RecordJan 24, 2025personal-care-homeclinical forms
CLI.6410.PL.004.FORM.03Personal Care Home and Transitional Care Unit Emergency Restraint ToolJan 24, 2025personal-care-homeclinical forms
CLI.6410.PL.004.FORM.02Personal Care Home and Transitional Care Unit Interim Restraint Assessment ToolJan 24, 2025personal-care-homeclinical forms
CLI.6410.PL.004.FORM.01Personal Care Home and Transitional Care Unit Restraint Assessment ToolJan 24, 2025personal-care-homeclinical forms
CLI.6410.PL.004.FORM.04Personal Care Home and Transitional Care Unit Restraint Care PlanJan 24, 2025personal-care-homeclinical forms
CLI.5810.FORM.017.FRBirthing Wishes FrenchJan 24, 2025obstetricsclinical forms
CLI.5413.SG.001.Form.01Application Assessment for LTC Panel Presentation FormJan 17, 2025home-carecase-coordination clinical forms
CLI.5413.SG.001.Form.02Application for Personal Care Home ChecklistJan 17, 2025home-carecase-coordination clinical forms
ORG.1110.PL.002.SD.01Graphic Standards ManualAdded additional information re. Alt Text to support accessibility standardsJan 14, 2025communicationsorganizational
CLI.6410.PL.019.FORM.01Change of Circumstance FormJan 10, 2025personal-care-homeclinical forms
Manitoba Guidelines for Perinatal Testing and AdministrationJan 7, 2025obstetricsclinical
Manitoba RH Program ObstetricsJan 7, 2025obstetricsclinical
CLI.5810.FORM.023Medication Administration Record MAR STAT and Non Recurrent Medications POSTPARTUMPharmacy collaboration to update Obstetrical MARS format/template in preparation for transition to CMAR. These updated MARS will be available in print form until CMAR program includes Obstetrical MARSJan 1, 2025obstetricsclinical forms
CLI.5810.FORM.020Medication Administration Record MAR STAT and Non Recurrent Medications LABOUR and DELIVERYPharmacy collaboration to update Obstetrical MARS format/template in preparation for transition to CMAR. These updated MARS will be available in print form until CMAR program includes Obstetrical MARSJan 1, 2025obstetricsclinical forms
CLI.4110.FORM.004Job Aid TemplateA tool or guide that is used to provide instruction/direction on how to complete a task or outlines a workflow process at the program, facility or unit level. Sometimes these are also referred to as ‘Standard Operating Procedures’ or ‘SOPs’, terminology may vary from program to program or facility to facilityJan 1, 2025across-care-areasclinical forms
CLI.5810.FORM.018Medication Administration Record (MAR) STAT and Non-Recurrent Medications PRE-OPERATIVE CESAREAN SECTIONPharmacy collaboration to update Obstetrical MARS format/template in preparation for transition to CMAR. These updated MARS will be available in print form until CMAR program includes Obstetrical MARSJan 1, 2025obstetricsclinical forms
CLI.5810.FORM.021Medication Administration Record (MAR) SCHEDULED Medications and Infusions LABOUR and DELIVERYPharmacy collaboration to update Obstetrical MARS format/template in preparation for transition to CMAR. These updated MARS will be available in print form until CMAR program includes Obstetrical MARSJan 1, 2025obstetricsclinical forms
CLI.4110.SG.006Blood Glucose Monitoring Skin Puncture MethodUpdate policy as greater than 3 years since last review. Reflects updated Accreditation requirements - keep QC records for 2 years, add regular education for nurses - SD to add in 2025. Streamlined from original to include Elsevier resources and links to existing SH-SS policies for action required for results.Dec 30, 2024across-care-areasclinical
CLI.4110.SG.006.FORM.01Nova Glucometers Quality Control RecordDec 30, 2024across-care-areasclinical forms
NS-2202.000Reprocessing Of Flexible Endoscopes 180 SeriesDec 30, 2024medical-device-reprocessingclinical
CLI.5510.PL.004Reprocessing of Flexible EndoscopeMinimize patient risk and prevent healthcare associated transmission of micro-organisms. Endoscopes are delicate, expensive equipment that require handling by knowledgeable staff.Dec 30, 2024medical-device-reprocessingclinical
CLI.5510.PL.004.FORM.01Scope Reprocessing and Cabinet Cleaning FormMinimize patient risk and prevent healthcare associated transmission of micro-organisms. Endoscopes are delicate,expensive equipment that require handling by knowledgeable staff.Dec 30, 2024medical-device-reprocessingclinical forms
CLI.5510.PL.004.SD.01Scope Reprocessing and Cabinet Cleaning Form SampleMinimize patient risk and prevent healthcare associated transmission of micro-organisms. Endoscopes are delicate,expensive equipment that require handling by knowledgeable staff.Dec 30, 2024medical-device-reprocessingclinical
CLI.4110.PL.032Secure Messaging for Patient CareDec 30, 2024across-care-areasclinical
CLI.6010.PL.016.SD.01Medication Automatic Substitution List Acute Care AdultAdded LMWH - dalteparin AND methotrexate sections (includes dose banding)Dec 30, 2024pharmacyclinical
ORG.1910.SG.002Kitchen CleaningNew-keeping staff and clients safe by maintaining a clean and sanitary kitchen by following Public Health and Manitoba Health StandardsDec 18, 2024support-serviceshousekeeping organizational
ORG.1912.PL.009Standardized RecipesAdded #5 in the guideline. New document is Added #5 in the guideline; Regional Portion Guidelines for preparing and serving meals to clientsDec 18, 2024support-servicesfood-services organizational
ORG.1912.PL.009.SD.01Regional Portion GuidelinesNew document is ORG.1912.PL.009.SD.01 Regional New portion guidelines for preparing and serving meals to clients.Dec 18, 2024support-servicesfood-services organizational
CLI.4510.PL.013Transfer of Patients Requiring Trained Escorts Acute CareNew policy to meet inpatient accreditation standard 4.5Dec 17, 2024across-hospital-unitsclinical
CLI.4410.PL.013.SD.01Patient Escort Information Sheet Form SampleDec 17, 2024across-hospital-unitsclinical
CLI.4510.PL.013.FORM.01Patient Escort Information Sheet FormDec 17, 2024across-hospital-unitsclinical forms
CLI.4510.SG.006.FORM.01Acute Coronary Syndrome ACS Suspected Standard OrdersNew Clinical Tools have potential to improve Emergency Department patient services/patient safety, improve ED workflow efficiency and allow for greater nurse autonomy/job satisfactionDec 17, 2024across-hospital-unitsclinical forms
ORG.1411.SG.003Secondary Use of Personal Health InformationDec 16, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PL.508Disclosure of Information to Affiliated FoundationsDec 16, 2024health-information-servicesorganizational privacy-and-access
ORG.1913.PR.001Tube Feed Pump Equipment ManagementRemoved the name of contracted Tube-Feed Pumps, and created a more efficient process for transferring and tracking TF pumps. The number and location of pump storage has changed, therefore procedure required updating. Added a new Supporting Document - sign in sign out sheet to support process.Dec 16, 2024support-servicesorganizational physical-plant
ORG.1410.PL.002.FORM.03Reinstatement of Privilegeschanging VP Medical to Regional Lead-Medical Services & CMODec 16, 2024health-information-servicesforms health-information organizational
ORG.1410.PL.002.FORM.01Notice of Suspension To Physicianchanging VP Medical to Regional Lead-Medical Services & CMODec 16, 2024health-information-servicesforms health-information organizational
ORG.1410.PL.002.FORM.02Notice of Suspension to Inform Health Information Services Nursing Unitschanging VP Medical to Regional Lead-Medical Services & CMODec 16, 2024health-information-servicesforms health-information organizational
ORG.1410.PL.003Management of Incomplete Health RecordsRenamed/revised policy to address alternatives and timelines to managing outstanding incomplete health record in prolonged situations not just for medical Staff departure but also noncompliance in accordance with ORG.1410.PL.003 Health Record Completion by Medical StaffDec 16, 2024health-information-serviceshealth-information organizational
ORG.1410.PL.003.SD.01Incomplete Health Record NoticeDec 16, 2024health-information-serviceshealth-information organizational
ORG.1410.PL.002Health Record Completion by Medical StaffDec 16, 2024health-information-serviceshealth-information organizational
ORG.1410.PL.002.SD.01Completion of Health Records StandardsCompletion of Health Records Standards to align with Provincial Medical Council Leadership endorsement of no longer requiring face sheet completion when thorough discharge summaries and OR reports are completedDec 16, 2024health-information-serviceshealth-information organizational
ORG.1913.PR.001.FORM.01Contracted Tube Feed Pump Sign In Sign Out FormDec 16, 2024support-servicesforms organizational
ORG.1110.FORM.015Email Signature TemplateUpdated Land acknowledgment link in signature blockDec 12, 2024communicationsforms organizational
CLI.5412.SG.003.FORM.01Vitamin B12 Injection FormDec 11, 2024home-careclinical forms nursing
CLI.5412.SG.003Vitamin B12 InjectionDec 11, 2024home-careclinical nursing
CLI.6410.PL.030Complementary and Alternative Therapies in PCH and TCUDec 9, 2024personal-care-homeorganizational
CLI.6410.030.SD.01.FComplementary and Alternative Therapies Information Sheet for Residents and Alternate Decision Makers FRENCHDec 9, 2024personal-care-homeclinical
CLI.6410.030.SD.01Complementary and Alternative Therapies Information Sheet for Residents and Alternate Decision MakersDec 9, 2024personal-care-homeclinical
CLI.6410.PL.030.FORM.03Indemnification and Hold Harmless AgreementDec 9, 2024personal-care-homeclinical forms
CLI.6410.PL.030.FORM.01Consent to Perform a Complementary or Alternative Therapy by an Authorized SHSS RepDec 9, 2024personal-care-homeclinical forms
CLI.6410.PL.030.FORM.02External Healthcare Provider Treatment Notes and Plan of CareDec 9, 2024personal-care-homeclinical forms
ORG.1110.PL.010.FORM.02Site content edit requestDec 6, 2024communicationsforms organizational
ORG.1110.PL.010Public and Staff WebsitesDec 6, 2024communicationsorganizational
CLI.6010.PL.042Acute Care Formulary ReviewDec 5, 2024pharmacyclinical
CLI.6010.PL.042.FORM.003Drug Review for Formulary RequestDec 5, 2024pharmacyclinical forms
CLI.6010.PL.042.FORM.002Formulary Addition Deletion Request FormDec 5, 2024pharmacyclinical forms
CLI.6010.PL.042.FORM.001Non Formulary Drug Approval Request FormDec 5, 2024pharmacyclinical forms
CLI.6010.PL.042.SD.001Non Formulary Medication Orders AlgorithmDec 5, 2024pharmacyclinical
CLI.6010.FORM.003Adult Intravenous Iron AdministrationDec 5, 2024pharmacyclinical forms
CLI.6010.FORM.014Acetaminophen Overdose Treatment Standard OrdersChanged units on page 2 10 mcg/mL to 10 mg/L, removed bicarbonate in the investigations and initial presentation test list as well as the repeat test.Dec 1, 2024pharmacyclinical forms standard-order
CLI.5810.PL.011Perinatal Lossupdated "remains of stillbirth or neonatal death" section to align with new SharedHealth changes in processes for Forms and Autopsy process. updated guideline onto new SH-SS Guideline templateNov 29, 2024obstetricsclinical
CLI.5810.SG.007Management of Hypoglycemia in the NeonateNov 29, 2024obstetricsclinical
CLI.4110.PL.023.SD.02Criteria and Checklist for Starting Tube Feeds in Small Acute FacilitiesRevised to align with the Provincial Tube Feed Pump conversionNov 28, 2024across-care-areasclinical
CLI.4110.PL.023Adult Enteral Nutrition Acute and Personal Care Home PCH ClientsRevised to align with the provincial tube feed pump conversionNov 28, 2024across-care-areasclinical
CLI.4110.PL.023.SD.01Regional Order Guide Tube Feed Supplies for Enteral NutritionRevised to align with the Provincial Tube Feed Pump conversionNov 28, 2024across-care-areasclinical
ORG.1410.PL.201.SD.01Retention Schedule of Personal Health Informationrevision of retention period for paper index cards from permanent to 20 years after the implementation of an electronic ADT. the paper index cards will not serve a business purpose after the minimum retention period.Nov 21, 2024health-information-servicesorganizational
Applicant Tracking Screening Tool Nov 19, 2024human-resourcesforms
CLI.6410.PL.033Non forced Care in PCHs and TCUsNov 14, 2024personal-care-homeclinical
CLI.6410.PL.029PCH Transportation CostsNov 14, 2024personal-care-homeclinical
CLI.6410.PL.013Transfer of Residents Requiring Trained EscortsNov 14, 2024personal-care-homeclinical
CLI.4110.PL.031Safe Bed Rail Use in CommunityNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.05.FSafe Bed Rail Use Client Family FrenchNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.05Safe Bed Rail Use Client FamilyNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.04Sleep Observation Study for Bed Rail UseNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.03Bed Rail alternative strategies chartNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.02Bed Rail Safety AlgorithmNov 13, 2024across-care-areasclinical
CLI.4110.PL.031.SD.01Bed Rail and Alternative EquipmentNov 13, 2024across-care-areasclinical
Job Posting Request Nov 13, 2024human-resourcesforms
CLI.6010.PL.009.FORM.05Obstetrical Best Possible Medication History BPMH and Reconciliation Admission and Dischargeremoved n/a for faxing to pharmacyNov 7, 2024pharmacyclinical forms
CLI.5510.PL.010.FORM.01Sterilization Requalification RecordNov 3, 2024medical-device-reprocessingclinical forms
CLI.5510.PL.010Operational Qualification and Requalification of Steam SterilizerNov 3, 2024medical-device-reprocessingclinical
CLI.5510.PL.009Performance Qualification of Surgical Instrument Sets and Medical DevicesNov 3, 2024medical-device-reprocessingclinical
CLI.6611.FORM.007Intraoperative Recordadded section for ml under Local Anesthetic and Xylocaine ViscousNov 1, 2024perioperativeclinical forms surgical-unit-same-day-surgery
CLI.5810.PL.005.SD.05Intrauterine Resuscitation TechniquesUpdated document according to SOGC Guideline and Best Practice.Nov 1, 2024obstetricsclinical
CLI.5810.PL.005.SD.04Algorithm for Cervical Ripening and Induction of LabourUpdated document according to SOGC Guideline and Best PracticeNov 1, 2024obstetricsclinical
CLI.8011.PL.023Respiratory Virus Season Planning and Response in Acute CareIP&C has amalgamated 2 policies to provide clear direction for Acute Care.Nov 1, 2024infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.5810.PL.002.SD.02Misoprostol Titration ProtocolNov 1, 2024obstetricsclinical
CLI.8011.PL.004.FORM.01Outbreak Line ListUpdated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policyNov 1, 2024infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.5510.PL.009.FORM.01Performance Qualification RecordNov 1, 2024medical-device-reprocessingclinical forms
CLI.4110.PL.030.SD.04.FInterfacility Transfer Poster FrenchGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical
CLI.4110.PL.030.SD.04Interfacility Transfer PosterGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical
CLI.4110.PL.030.SD.03Interfacility Transfer Communication Pathway AlgorithmGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical
CLI.4110.PL.030.SD.02Escalation Process Pathway AlgorithmGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical
CLI.4110.PL.030.SD.01Capacity Management Protocol Actions Specific to Respiratory Virus SeasonGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical
CLI.4110.PL.030.FORM.02Capacity Management Protocol Site Plan Regional CentreGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical forms
CLI.4110.PL.030.FORM.01Capacity Management Protocol Site Specific Plan Community Acute SiteGoal is to facilitate cooperation between stakeholders within SH-SS to support a system approach to capacity management.Nov 1, 2024across-care-areasclinical forms
Position Description TemplateNov 1, 2024human-resourcesforms
CLI.5810.PL.005Cervical RipeningNov 1, 2024obstetricsclinical
CLI.5810.Pl.005.SD.01Cervical Ripening BilingualNov 1, 2024obstetricsclinical
CLI.5810.PL.005.SD.02Cervical Ripening handout – GermanNov 1, 2024obstetricsclient-teaching-handouts clinical
CLI.5810.PL.005.SD.03Going Home after Cervical RipeningNov 1, 2024obstetricsclinical
CLI.5810.PL.002.FORM.01Induction Checklistdeveloped to guide staff and patients on use of oxytocinNov 1, 2024obstetricsclinical forms
CLI.5810.PL.002Induction Augmentation of Labourdeveloped to guide staff and patients on use of OxytocinNov 1, 2024obstetricsclinical
CLI.5110.SG.009.FORM.01Anaphylaxis Standard Ordersremoved MTCC contact info with VECTRSNov 1, 2024critical-care-er-observation-scuclinical forms
CLI.5810.SG.007.SD.02Canadian Pediatric Society Management Hypoglycemia AlgorithmNov 1, 2024obstetricsclinical
CLI.5810.SG.007.SD.01Measuring Insturctions for Glucose Gel for NewbornsNov 1, 2024obstetricsclinical
CLI.8011.PL.004Outbreak Management Respiratory including Influenza and COVID 19 and GastrointestinalUpdated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policyNov 1, 2024infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.5810.FORM.026Medication Administration Record MAR SCHEDULED 7 Day NEWBORNNov 1, 2024obstetricsclinical forms
CLI.5810.FORM.025Medication Administration Record MAR STAT and Non Recurrent Medications NEWBORNNov 1, 2024obstetricsclinical forms
CLI.5810.FORM.024Medication Administration Record MAR PRN 7 Day POSTPARTUMNov 1, 2024obstetricsclinical forms
CLI.5810.FORM.022Medication Administration Record MAR SCHEDULED 7 Day PERINATALNov 1, 2024obstetricsclinical forms
CLI.5810.FORM.019Medication Administration Record MAR PRN 7 Day LABOUR and DELIVERYNov 1, 2024obstetricsclinical forms
CLI.6010.PL.008Patients Own MedicationsAdded section/process for PCH and changed the nameOct 24, 2024pharmacyclinical
CLI.6010.PL.016.SD.02PCH Automatic Substitution ListOct 24, 2024pharmacyclinical
ORG.1410.PL.201.FORM.01Record of Destruction LogOct 10, 2024health-information-servicesforms organizational
ORG.1410.PL.201Retention and Destruction of Personal Health InformationRemoved retention period for blood and blood products - to follow minimum retention period of discharges - therefore step to purge record for same was deleted. removed statement that records may be kept longer if space available.Oct 10, 2024health-information-serviceshealth-information organizational
ORG.1411.SG.002Disclosure of Personal Health Information for Review by Health Care Professionals and or a Professional Regulatory BodyTo provide direction when a request is received by a Health Care Professional's legal counsel for the disclosure of personal health information.Oct 10, 2024health-information-servicesorganizational privacy-and-access
CLI.8011.FORM.002Chickenpox Shingles Screening Checklisttool was designed to provide explanation to staff and give the knowledge required to provide safe patient care and ensure safe practices to staffOct 9, 2024infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.4510.PR.002.FORM.13Prescriber Order Sheetadded DNUA tableOct 1, 2024across-hospital-unitsclinical forms
CLI.6010.FORM.020LTC Paxlovid Standard OrderOct 1, 2024pharmacyclinical forms standard-order
CLI.5810.PL.002.SD.01.FOxytocin to Start or Advance Labour 5 Questions to Ask FrenchSep 23, 2024obstetricsclinical
CLI.5810.PL.002.SD.01Oxytocin to Start or Advance Labour 5 Questions to AskSep 23, 2024obstetricsclinical
CLI.5810.PL.002.FORM.04Misoprostol Safety ChecklistSep 23, 2024obstetricsclinical forms
CLI.5810.PL.002.FORM.03Pre and In Use Oxytocin Safety ChecklistSep 23, 2024obstetricsclinical forms
CLI.5510.PL.006Reprocessing of Flexible Endoscope in the event the Automatic Endoscope Reprocessor is not functioningTo ensure equipment is not functioning, proper manual cleaning and disinfecting prior to the storage of scope is required.Sep 23, 2024medical-device-reprocessingclinical
CLI.5510.PL.006.FORM.01Manual Endoscope Reprocessing FormTo ensure equipment is not functioning, proper manual cleaning and disinfecting prior to the storage of scope is required.Sep 23, 2024medical-device-reprocessingclinical forms
CLI.5510.PL.003Presoak of the Flexible Endoscopes Following Excessive Bleeding and or Delayed ReprocessingTo ensure proper cleaning and reprocessing of Endoscopes for patient safetySep 23, 2024medical-device-reprocessingclinical
CLI.5510.PL.002.SD.01Inter MDR Transportation of Instrumentation GuideBest Practices for transporting clean and sterile supplies to ensure safety staff and patients.Sep 23, 2024medical-device-reprocessingclinical
CLI.5510.PL.002.FORM.02MDR Interdepartmental Instrument TrackingBest Practices for transporting clean and sterile supplies to ensure safety staff and patients.Sep 23, 2024medical-device-reprocessingclinical forms
CLI.5510.FORM. 01Endoscope LogTracking record required for reprocessing endoscopesSep 23, 2024medical-device-reprocessingclinical forms
CLI.5510.PL.002Transportation of Clean and Sterile SuppliesBest Practices for transporting clean and sterile supplies to ensure safety staff and patients.Sep 23, 2024medical-device-reprocessingclinical
CLI.5510.PL.001Loaned Shared or Leased Critical Semi Critical Medical DevicesBest Practices for having surgical equipment available for patient safetySep 23, 2024medical-device-reprocessingclinical
CLI.5510.PL.001.FORM.01Loaner Communication RecordBest Practices for having surgical equipment available for patient safetySep 23, 2024medical-device-reprocessingclinical forms
CLI.5910.PL.007.FORM.01Palliative Care Standard Orders FormSep 22, 2024palliative-careclinical forms standard-order
CLI.6210.SG.008Public Health Response to Animal Exposures to Prevent Human Rabies GuidelineDocument and process in need of review and update.Aug 30, 2024public-health-healthy-livingclinical
ORG.1810.PL.001.FORM.01Safety Event ReportUpdate after hours information under Notifications section of reportAug 28, 2024quality-planning-and-performanceforms organizational
CLI.4110.PL.029.FORM.01Diet Change Form Personal Care HomeImprove accuracy of diet information. Have diet information written and reduce risk of error. Streamlined/Regionalized the forms.Aug 27, 2024across-care-areasclinical forms
ORG.1110.PL.003Media Relations and RequestsAug 26, 2024communicationsorganizational
Template Activity DescriptionAug 14, 2024human-resourcesforms
PCH Tracking Sheet for Narcotic ReturnsAug 8, 2024pharmacyforms
CLI.8011.PL.022.SD.02.FCarbapenemase Producing Enterobacteriaceae CPE Fact Sheet FrenchHarmonizing policy. To provide direction from SH-SS staff in caring for ARO positive/suspect clients across all care areas.Aug 1, 2024infection-prevention-and-controlclinical
CLI.8011.PL.022.SD.02Carbapenemase Producing Enterobacteriaceae CPE Fact SheetHarmonizing policy from other regions. To provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas.Aug 1, 2024infection-prevention-and-controlclinical
CLI.8011.PL.022.SD.01.FMethicillin Resistent Staphylococcus aureus MRSA Fact Sheet FrenchHarmonizing policies to provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas.Aug 1, 2024infection-prevention-and-controlclinical
CLI.8011.PL.022.SD.01Methicillin Resistent Staphylococcus aureus MRSA Fact SheetHarmonizing policies to provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas.Aug 1, 2024infection-prevention-and-controlclinical
CLI.8011.PL.022Management of Antimicrobial Resistant Organisms AROsHarmonizing policy. To provide direction for SH-SS staff in caring for ARO positive/suspect clients across all care areas.Aug 1, 2024infection-prevention-and-controlclinical
ORG.1110.PL.002.FORM.01Communication Support RequestAug 1, 2024communicationsforms organizational
CLI.6010.FORM.004Pharmacy Order Form Public Health Anaphylaxis KitsAug 1, 2024pharmacyclinical forms
CLI.5510.FORM.002High Level Disinfection LogTracking record for following current CSA Standards for High Level Disinfecting instrumentation.Aug 1, 2024medical-device-reprocessingclinical forms
CLI.6210.PL.004Immunization – Investigations – Public Health Information Management System PHIMS Access via Terms of Use AgreementUpdate required and new language to be used in identifying new system in use for immunizations and investigations (Panorama is now referred to as PHIMS)Jul 30, 2024public-health-healthy-livingclinical
CLI.6210.PL.004.SD.01Downtime and Recovery Procedures for PHIMSUpdate required and new language to be used in identifying new system in use for immunizations and investigations (Panorama is now referred to as PHIMS)Jul 30, 2024public-health-healthy-livingclinical
CLI.6310.FORM.002Inpatient ReferralRehabilitation Services Inpatient Referral Form revised to include under the Occupational Therapy column - high falls risk as indicated by "Falls Risk Assessment and Interventions for Inpatients" toolJul 30, 2024rehabilitation-therapy-servicesclinical forms
CLI.4110.SG.013.FORM.01Wound Assessment and Treatment FormJul 22, 2024across-care-areasclinical forms
Wound Consult FormJul 18, 2024infection-prevention-and-controlforms
Return to Work ScheduleJul 16, 2024human-resourcesability-management forms
ORG.1710.PL.010.FORM.04Driver Fitness DeclarationJul 15, 2024logistics-and-supply-chain-managementorganizational
ORG.1411.PL.002.SD.01Request for Access Response Coordination Process Flow ChartPolicy revised to reflect amendments to FIPPA. Procedures included in ORG.1411.PR.001 & name changed to reflect same. Supporting document updated and name changed from FIPPA Process Overview April 2015Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1410.PL.008Control of Health RecordsTo define guidelines for the removal and return of health records to Health Information Services. Some sites face challenges with records returning in a timely manner.Jul 8, 2024health-information-serviceshealth-information organizational
ORG.1411.PL.002.FORM.01Application for Access FormPolicy revised to reflect amendments to FIPPA. Procedures included in ORG.1411.PR.001 & name changed to reflect same. Supporting document updated and name changed from FIPPA Process Overview April 2015.Jul 8, 2024health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.002.SD.02Third Party Consult Flow ChartPolicy revised to reflect amendments to FIPPA. Procedures included in ORG.1411.PR.001 & name changed to reflect same. Supporting document updated and name changed from FIPPA Process Overview April 2015.Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PR.002Third Party Consultation Process under The Freedom of Information and Protection of Privacy ActTo further provide direction related to the Third Party consultative process under FIPPA.Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PR.001Request for Access Response Coordination Process under The Freedom of Information and Protection of Privacy ActCreated procedure that aligns with amendments to FIPPA. To provide a step by step process for responding to requests to access records under FIPPA.Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PR.001.FORM.01The Freedom Information and Protection of Privacy Act Communication TemplateCreated procedure that aligns with amendments to FIPPA. To provide a step by step process for responding to requests to access records under FIPPA.Jul 8, 2024health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.004Correction of Personal Information Under The Freedom of Information and Protection of Privacy ActRevised to reflect amendments to FIPPA and new SH-SS format.Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PL.003Administration Responsibilities Under The Freedom of Information and Protection of Privacy ActUpdate to reflect amendments to FIPPA. New format.Jul 8, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PL.002Access to Information and Processing of Requests under FIPPAPolicy revised to reflect amendments to FIPPA. Procedures included in ORG.1411.PR.001 & name changed to reflect same. Supporting document updated and name changed from FIPPA Process Overview April 2015.Jul 8, 2024health-information-servicesorganizational privacy-and-access
CLI.4110.SG.013Wound Assessment and Treatment Flow SheetGuidance for nursing staff on how and when to document on woundsJul 3, 2024across-care-areasclinical
CLI.8011.PL.018.FORM.02Healthcare Associated Infection Surveillance Forms – Personal Care HomesDefinitions for healthcare associated infection has been revisedJul 3, 2024infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.018.FORM.01Healthcare Associated Infection Surveillance Form – Acute CareDefinition for healthcare associated infections have been revised.Jul 3, 2024infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.018Surveillance of Healthcare Associated Infections in Acute Care and Personal Care HomesDefinitions for healthcare associated infections have been revised. Policy now reflects the inclusion and roles of the Regional LTC IP&C Nurse and Infection Control Support Associates.Jul 3, 2024infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6410.PL.021.FORM.05Suicide Risk Assessment in Personal Care Homes Policy Implementation AuditAdditional requirement addedJul 3, 2024personal-care-homeclinical forms
CLI.6410.PL.021Suicide Risk Assessment in Personal Care HomesAddition of the Policy Audit summary tool and change of audit dateJul 3, 2024personal-care-homeclinical
CLI.6410.PL.021.FORM.06Suicide Risk Assessment in Personal Care Homes Policy Implementation Audit SummaryCreated to assist PCHs to summarize audit data for entry into the reporting spreadsheetJul 3, 2024personal-care-homeclinical forms
Quality Improvement Plan TemplateJul 2, 2024quality-planning-and-performanceforms
CLI.4510.PL.008.SD.03What You and Your Family Need to Know bilingual handoutOne pager was revised to reflect insert QR code hereJul 2, 2024across-hospital-unitsclinical
CLI.5910.PL.001.FORM.01Palliative Care Referral FormJun 1, 2024palliative-careclinical forms
CLI.5910.PL.001.FORM.01.FPalliative Care Referral Form FrenchJun 1, 2024palliative-careclinical forms
CLI.6410.PL.001.FORM.02Resident Experience Survey PosterMay 31, 2024personal-care-homeclinical forms
CLI.6410.PL.001.FORM.01Resident Experience SurveyMay 30, 2024personal-care-homeclinical forms
CLI.6410.PL.001Resident Experience Survey in Personal Care HomesMay 30, 2024personal-care-homeclinical
CLI.6410.PL.031Resident RightsA guide for PCHs to use regarding residents rightsMay 28, 2024personal-care-homeclinical
CLI.6410.PL.031.FORM.01Observational Audit Tool Resident Bill of RightsMay 28, 2024personal-care-homeclinical forms
CLI.6410.PL.001.FORM.01.FResident Experience Survey – FrenchMay 25, 2024personal-care-homeclinical forms
Indigenous Self Declaration 2024May 18, 2024forms
CLI.6210.PL.002Immunization Obtaining and Documenting Informed ConsentMay 15, 2024public-health-healthy-livingclinical
CLI.6110.FORM.003Nutrition Assessment Acute CareMay 3, 2024primary-health-careclinical forms
Volunteer Reference Check FormMay 1, 2024human-resourcesforms
Template Letter to accompany RCMPMay 1, 2024human-resourcesforms
Template Letter to accompany RCMP – FrenchMay 1, 2024human-resourcesforms
Template Letter to RCMPMay 1, 2024human-resourcesforms
Template Hours of Service RecordMay 1, 2024human-resourcesforms
CLI.5810.FORM.051Standard Orders Labour and DeliveryChanges to reflect best practice updates.Apr 29, 2024obstetricsclinical forms standard-order
CLI.5810.FORM.024Perinatal Scheduled Medications and Infusions Medication Administration RecordApr 29, 2024obstetricsclinical forms
CLI.6410.PL.032.FORM.01Elopement Risk ScaleApr 25, 2024personal-care-homeclinical forms
CLI.6410.PL.032Wandering Elopement in Personal Care Homes and Transitional Care UnitsProvide direction for PCH/TCU on how to deal with Wandering/Elopement issuesApr 25, 2024personal-care-homeclinical
New Inventory Item New SKUApr 19, 2024logistics-and-supply-chain-managementforms
Medication CardApr 12, 2024palliative-careforms
Medication PRN ChartingApr 12, 2024palliative-careforms
SWP Training Sign in SheetApr 11, 2024human-resourcesforms
CLI.4110.PR.003Permanent Bed Map ChangesSH-SS is responsible for the planning and coordination of health care services within region. One aspect of this coordination is the development & maintenance of a current bed map to promote an adequate bed base.Apr 9, 2024across-care-areasclinical
CLI.4110.PR.004Temporary Bed Map ChangesSH-SS is responsible for planning and coordinating the current med map to promote an adequate bed case and to trend bed changes over time.Apr 9, 2024across-care-areasclinical
CEO Career Achievement Award NominationApr 5, 2024human-resourcesforms
Service Excellence Team Award NominationApr 5, 2024human-resourcesforms
ORG.1511.PL.012Out of Scope Mobility with Employer OrganizationsApr 2, 2024human-resourcesorganizational recruitment-and-retention
ORG.1910.PR.062Carbolizing of a Maternity BedDirection for staff to follow and incorporate methods necessary to sustain the facility’s environment at a level of sanitation and visual appearance, consistent with the Accreditation Standards, Infection Control and Manitoba Health Standards.Mar 26, 2024support-serviceshousekeeping organizational
CLI.6410.PL.009.FORM.02Medication Delivery Practice Audit SummaryMar 25, 2024personal-care-homeclinical forms
CLI.6410.PL.009.FORM.01Medication Delivery Practice Audit ToolMar 25, 2024personal-care-homeclinical forms
CLI.6410.PL.009Medication Delivery Practice AuditMar 25, 2024personal-care-homeclinical
CLI.6410.PL.027.FORM.01Regional Bathing Log Form Option 1Mar 25, 2024personal-care-homeclinical forms
CLI.6410.PL.027.FORM.02Regional Bathing Log Form Option 2Mar 25, 2024personal-care-homeclinical forms
CLI.6410.PL.004.SD.01Restaint in Personal Care Home and Transitinal Care Unit Client Teaching HandoutRevised to update current restraints standards and to clearly identified restraintsMar 25, 2024personal-care-homeclient-teaching-handouts clinical
CLI.6410.PL.027.SD.01Bathing Flowsheet for Resident in PCHMar 25, 2024personal-care-homeclinical
CLI.6410.PL.027.SD.02Alternate Bathing Tech PosterMar 25, 2024personal-care-homeclinical forms
CLI.4110.PL.028Overhead Lifts for Community Clientsto define the assessment, eligibility criteria and approval/purchase processMar 19, 2024across-care-areasclinical
CLI.8011.PL.002Admission Screening for Antibiotic Resistent Organisms AROsMar 13, 2024infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.002.SD.01Antibiotic Resistant Organism Flagging Codes and Required ActionsMar 13, 2024infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.002.FORM.01Antibiotic Resistent Organisms Admission ScreeningMar 13, 2024infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.4110.PL.028.FORM.04Overhead Lift Tracking Tooltracking tool for clients and equipmentMar 8, 2024across-care-areasclinical forms
CLI.4110.PL.028.FORM.06Overhead Lift Afterhours Home Care Rehab Services Troubleshooting Processafterhours troubleshooting document for overhead liftsMar 8, 2024across-care-areasclinical forms
CLI.4110.PL.028.FORM.05.FOverhead-Lift-Client-and-Family-Information – FrenchMar 8, 2024across-care-areasclinical
CLI.4110.PL.028.FORM.05Overhead Lift Client and Family InformationMar 8, 2024across-care-areasclinical
CLI.4110.PL.028.FORM.02Overhead lift consent for installationMar 8, 2024across-care-areasclinical forms
CLI.4110.PL.028.FORM.03Overhead Lifts Prioritization Criteria Level of RiskMar 8, 2024across-care-areasclinical forms
ORG.1810.PL.003.FORM.01Compliment and Concern FormMar 1, 2024quality-planning-and-performanceforms organizational
ORG.1810.PL.003Compliments and Concerns ManagementTo simplify the complaint process as there were 19 documents attached to the previous policy. The revised P&P title was modified as Compliments and Concerns Management to improve staff morale, productivity and retention. It has a total of 3 documents.Mar 1, 2024quality-planning-and-performanceorganizational
ORG.1810.PL.003.SD.01Compliments and Concerns Management ChecklistTo simplify the complaint process as there were 19 documents attached to the previous policy. The revised P&P title was modified as Compliments and Concerns Management to improve staff morale, productivity and retention. It has a total of 3 documents.Mar 1, 2024quality-planning-and-performanceorganizational
CLI.4110.PL.028.FORM.07Overhead Lift Performance Indicator Trackingaudit process for overhead liftsMar 1, 2024across-care-areasclinical forms
CLI.6110.FORM.007Out of Hospital Neonatal Resuscitation RecordOld RHA forms standardized into one formMar 1, 2024primary-health-careclinical forms
CLI.4510.FORM.001Central Registration Request FormForm revised to include the capability to communicate reopening and closing of beds to update EPR, when HIS at sites are not available. The electronic process was implemented in 2018 to improve efficiency and legibility. The form has been designed to capture required data elements for patient registration received by Central Registration.Mar 1, 2024across-hospital-unitsclinical forms
Manitoba Personal Tax Credit Form FederalFeb 28, 2024human-resourcesforms
2024 Manitoba Personal Tax Credit FormFeb 28, 2024human-resourcesforms
CLI.4110.FORM.001BRHC HSAH Adult General Surgery Post Operative Standard OrdersUpdated with metroNIDAZOLE doseFeb 23, 2024across-care-areasclinical forms
CLI.4110.FORM.003Post Operative Adult Urology Standard Orders revisedUpdated with metroNIDAZOLE doseFeb 23, 2024across-care-areasclinical forms
CLI.6410.PL.017.FORM.02Regional Long Term Care Panel Acceptance LetterFeb 21, 2024personal-care-homeclinical forms
CLI.4110.PL.028.FORM.01Overhead Lift Request Approvalapproval form for overhead lifts for community clientsFeb 14, 2024across-care-areasclinical forms
Mentorship EvaluationFeb 12, 2024forms
CLI.4110.FORM.002Hopital Ste.Anne Hospital Urology Surgery Program Thulium Laser LogStandardizing documentation for staff to useFeb 1, 2024across-care-areasclinical forms
ORG.1410.PR.001Securing Health RecordsFeb 1, 2024health-information-serviceshealth-information organizational
ORG.1410.PR.001.FORM.02Secured Health Records LogFeb 1, 2024health-information-servicesforms health-information organizational
ORG.1410.PR.001.FORM.01Health Record Safekeeping Control ReportFeb 1, 2024health-information-servicesforms health-information organizational
FLS Underfill RequestFeb 1, 2024french-language-servicesforms
ORG.1410.PL.101.SD.01Standard Operating Procedure for Recording and Reporting Alternate Level of Care ALCAdded as a supporting document within the ALC Policy- Alternate Level of Care (ALC) to provide support to the health care team in implementing a process change - using the completed ALC designation form to also report ALC in the ADT EPRJan 29, 2024health-information-serviceshealth-information organizational
ORG.1410.PL.101.FORM.01Alternate Level of Care Designation RecordStandard Operating Procedure Org.1410.PL.101.FORM.02 has been added as a supporting document within the ALC Policy- Alternate Level of Care (ALC) to provide support to the health care team in implementing a process change - using the completed ALC designation form to also report ALC in the ADT EPRJan 29, 2024health-information-servicesforms health-information organizational
ORG.1410.PL.101Alternate Level of CareUpdated provincial ALC designation form ORG.1410.PL.101.FORM.01, which is a supporting document within the policy. Standard Operating Procedure Org.1410.PL.101.FORM.02 has been added as a supporting document to provide support to the health care team in implementing a process change - using the completed ALC designation form to also report ALC in the ADT EPRJan 29, 2024health-information-serviceshealth-information organizational
CLI.6010.PL.005Automatic Reassessment of Medication OrdersJan 25, 2024pharmacyclinical
CLI.6010.PL.003Regional Parenteral Drug Monograph Manual and Use of Infusion SMART PumpsRevised name to reflect with Use of Infusion SMART PumpsJan 25, 2024pharmacyclinical
CLI.6010.PR.002Use of Single and Multi Dose Vials in Patient Care AreasSlight revisions to existing practice requiring Independent Double Check.Jan 25, 2024pharmacyclinical
CLI.6010.PL.015.SD.02MAR Example LTC Patch Application and RemovalImpact to clinical practices. slight revisions to existing requiring independent double check.Jan 25, 2024pharmacyclinical
CLI.6010.PL.005.SD.01MAR Example LTC Warfarin MonitoringSlight revisions to existing practice requiring independent double check.Jan 25, 2024pharmacyclinical
CLI.6010.PL.015Narcotics and Controlled DrugsImpact to clinical practice - slight revisions to existing practice requiring independent double checkJan 25, 2024pharmacyclinical
ORG.1912.PL.003.SD.01Bringing in Food from HomeJan 23, 2024support-servicesfood-services organizational
CLI.4110.PL.004.SD.01Central Venous Access Devices Locking Solutions GuidelineMinor wording correction to policy on page 14, bullet point 8.2.5 for clarity. Adjustment to supporting document to match policy. Updated based on best practice evidence, the most current guidelines and policies from the Canadian Vascular Access Association (CVAA) and Infusion Nurses Society (INS) as well as input from vascular access subject matter experts (SMEs).CLI.4110.PL.004.FORM.01 - Alteplase (Cathflo®) Standard Order- to be discontinued and archived.Jan 22, 2024across-care-areasclinical
CLI.4510.PL.008.SD.01Patient Handbook English templatePatient Info handbook template as the current version did not meet accessibility standardsJan 22, 2024across-hospital-unitsclinical
CLI.4510.PL.008.SD.02Patient Handbook French TemplatePatient Info handbook template as the current version did not meet accessibility standardsJan 22, 2024across-hospital-unitsclinical
CLI.4110.PL.004.FORM.01Central Venous Access Device Flow SheetUpdated based on best practice evidence, the most current guidelines and policies from the Canadian Vascular Access Association (CVAA) and Infusion Nurses Society (INS) as well as input from vascular access subject matter experts (SMEs). Alteplase (Cathflo®) Standard Order- to be discontinued and archived.Jan 19, 2024across-care-areasclinical forms
CLI.4110.PL.004Central Venous Access Device Care and MaintenanceJan 19, 2024across-care-areasclinical
CLI.4110.PL.022.FORM.03Ankle Brachial Pressure Index ABPI and Toe Brachial Pressure Index TBPI AssessmentNew information on waveforms available with references added; removal of brand names of stockings and replaced with categories.Jan 19, 2024across-care-areasclinical forms
CLI.4110.PL.022Ankle Brachial Pressure Index and Toe Brachial Pressure Index TestingNew information on waveforms available with references added; removal of brand names of stockings and replaced with categories.Jan 19, 2024across-care-areasclinical
CLI.4510.SG.006.FORM.03NSTEMI Unstable Angina Standard OrdersBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical forms
CLI.4510.SG.006.FORM.06NSTEMI Unstable Angina Standard Orders Chart AuditJan 19, 2024across-hospital-unitsclinical forms
CLI.5110.SG.013.SD.01Alcohol Withdrawal Assessment Flowsheet CIWA Ar Directions for UseJan 19, 2024critical-care-er-observation-scuclinical
CLI.5110.SG.013.FORM.02Alcohol Withdrawal Assessment Flowsheet CIWA ArJan 19, 2024critical-care-er-observation-scuclinical forms
CLI.5110.SG.013.FORM.01Adult Alcohol Withdrawal Treatment Standard OrdersJan 19, 2024critical-care-er-observation-scuclinical forms standard-order
CLI.5110.SG.013Management of a Patient with Alcohol Withdrawal in Emergency DepartmentsJan 19, 2024critical-care-er-observation-scuclinical
CLI.4510.SG.006.FORM.07Cardiac Care Patient Teaching RecordUpdated standard orders and guideline to reflect current best practices and minimize delays in access to Cath Lab.Jan 19, 2024across-hospital-unitsclinical forms
CLI.4510.SG.006.FORM.05Acute STEMI Reperfusion Standard Orders Chart AuditBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical forms
CLI.4510.SG.006.FORM.02Acute STEMI Reperfusion Standard OrdersBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical
CLI.4510.SG.006.FORM.04Acute Coronary Syndrome Suspected Standard Orders Chart AuditBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical forms
CLI.4510.SG.006Acute Coronary SyndromeBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical
CLI.4510.SG.006.FORM.08Heparin Infusion Standard Orders Acute Coronary SyndromeBest practice has changed in ACS. worked with Pharmacy and provincial Acute Coronary Syndrome Network to review and provide updated protocols for ACS. We had CI's related to the NSTEMI/Unstable Angina caremap and were due to make edits. so per the CI recommendation, we made the appropriate updates.Jan 19, 2024across-hospital-unitsclinical forms
Provincial High Alert Medications ListJan 19, 2024pharmacyclinical
Provincial Clinical Standard, Safety Controls for High Alert MedicationsJan 19, 2024pharmacyclinical
ORG.2110.PR.003.FORM.01.FWithdrawal of Application Refusal of Unit Form FrenchJan 18, 2024elderly-persons-housingforms organizational
ORG.2110.PR.003.FORM.01Withdrawal of Application Refusal of Unit FormJan 18, 2024elderly-persons-housingforms organizational
ORG.2110.PR.001.FORM.01Application for Elderly Persons HousingJan 18, 2024elderly-persons-housingforms organizational
ORG.2110.PR.001.FORM.01.FApplication for Elderly Persons Housing FrenchJan 18, 2024elderly-persons-housingforms organizational
ORG.1411.PL.507Texting with Clients Natural Supports and other StaffProvide direction to SH-SS staff when using texting as a method of communicating with clients, natural supports and other staff.Jan 15, 2024health-information-servicesorganizational privacy-and-access
ORG.1411.PL.507.SD.01Texting on Smart Phones in the Workplace Frequently Asked Questions FAQProvide direction to SH-SS staff when using texting as a method of communicating with clients, natural supports and other staff.Jan 15, 2024health-information-servicesorganizational privacy-and-access
ORG.1410.SG.001Encrypting Records using 7 Zip File ManagerJan 15, 2024health-information-serviceshealth-information organizational
ORG.1411.SG.002.SD.01Disclosure of PHI for Review by HCP andor a Professional Regulatory Body Letter TemplateJan 15, 2024health-information-servicesorganizational privacy-and-access
CLI.6410.PL.015Personal Electrical Appliances in Personal Care HomesJan 4, 2024personal-care-homeclinical
ORG.1810.PL.010Mandatory ReportingMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024quality-planning-and-performanceorganizational
ORG.1810.PL.010.FORM.01Gunshot and Stab Wound Mandatory Reporting FormMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024quality-planning-and-performanceforms organizational
ORG.1810.PL.010.SD.09Management of Manitoba Advocate for Children and Youth ChecklistMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024quality-planning-and-performanceorganizational
ORG.1810.PL.010.SD.08Management of Reportable Diseases and Conditions ChecklistMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024quality-planning-and-performanceorganizational
ORG.1810.PL.010.FORM.02Serious Injury Report FormJan 1, 2024quality-planning-and-performanceforms organizational
ORG.1810.PL.010.SD.07Management of a Reportable Medical Condition Posing a Danger to Operate a Motor Vehicle ChecklistJan 1, 2024quality-planning-and-performanceforms organizational
ORG.1910.PR.039Carbolizing of Beds and StretchersRevised to follow the cleaning of a bed / stretcher videoDec 29, 2023support-serviceshousekeeping organizational
ORG.1910.PR.026Terminal Cleaning of the Operating Room End of DayRevised to include cleaning of bed in the Operating Room and to give direction on cleaning specific OR items.Dec 29, 2023support-serviceshousekeeping organizational
ORG.1910.PR.061Removal and Replacement of On The Right Track CurtainsTo provide direction for all Southern Health - Santé Sud staff to follow and incorporate methods necessary to sustain the facility’s environment at a level of safety, sanitation and visual appearance, consistent with the Accreditation Standards, Infection Control and Manitoba Health Standards.Dec 29, 2023support-serviceshousekeeping organizational
ORG.1411.PL.404Security and Storage of Confidential Information including TransportationTo align with Digital Shared Services around the use of USB storage devices, specifically restricting the use of network connected devices to only accept encrypted USB storage devices.Dec 29, 2023health-information-servicesorganizational privacy-and-access
ORG.1411.PL.502.SD.01Personal Health Information Act PHIA DefinitionsIncluded definitions for alternate decision maker and healthDec 29, 2023health-information-servicesorganizational privacy-and-access
ORG.1411.PL.001.SD.01FIPPA DefinitionsDec 29, 2023health-information-servicesorganizational privacy-and-access
ORG.1411.PL.001Annual Reporting Under The Freedom of Information and Protection of Privacy Act FIPPADec 29, 2023health-information-servicesorganizational privacy-and-access
CLI.6410.PL.028Resident Safety CheckResidents living in Personal Care Homes (PCH) are to have checks individualized to the resident's circumstances and needs. This policy was developed to assist care providers in using critical thinking when providing 24-hour care.Dec 13, 2023personal-care-homeclinical
CLI.6210.SG.005.FORM.04Harm Reduction Supply Distribution Partner Site Agreement RegistrationDec 7, 2023public-health-healthy-livingclinical forms
CLI.6210.SG.005Harm Reduction Supply DistributionReviewed and updated by the Lead Communicable Disease Coordinator (CDC) for Harm Reduction (HR) alongside the entire Communicable Disease Coordinator Team which includes our 2 Southern Health Medical Officers of Health. Information and feedback has been obtained from cleints within the PHHL program who take part on our HR programming as well as staff who support cleints who request services as well as other partners within the community (iincluding peers)Dec 7, 2023public-health-healthy-livingclinical
CLI.6210.SG.005.FORM.05Disposal of Found Drugs or SubstancesReviewed and updated by the Lead Communicable Disease Coordinator (CDC) for Harm Reduction (HR) alongside the entire Communicable Disease Coordinator Team which includes our 2 Southern Health Medical Officers of Health. Information and feedback has been obtained from clients within the PHHL program who take part on our HR programming as well as staff who support clients who request services as well as other partners within the community (including peers)Dec 7, 2023public-health-healthy-livingclinical forms
CLI.6210.SG.005.FORM.02Harm Reduction Supply Distribution Inventory Tracking FormReviewed and updated by the Lead Communicable Disease Coordinator (CDC) for Harm Reduction (HR) alongside the entire Communicable Disease Coordinator Team which includes our 2 Southern Health Medical Officers of Health. Information and feedback has been obtained from cleints within the PHHL program who take part on our HR programming as well as staff who support cleints who request services as well as other partners within the community (iincluding peers)Dec 7, 2023public-health-healthy-livingclinical forms
CLI.6210.SG.005.FORM.03Harm Reduction Supply Distribution OrderReviewed and updated by the Lead Communicable Disease Coordinator (CDC) for Harm Reduction (HR) alongside the entire Communicable Disease Coordinator Team which includes our 2 Southern Health Medical Officers of Health. Information and feedback has been obtained from cleints within the PHHL program who take part on our HR programming as well as staff who support cleints who request services as well as other partners within the community (iincluding peers)Dec 7, 2023public-health-healthy-livingclinical forms
ORG.1110.PL.004.FORM.01Photo Video Audio Consent FormRevised form to comply with accessibility.Dec 4, 2023communicationsforms organizational
Leave of AbsenceNov 27, 2023human-resourcesforms
CLI.6110.FORM.004Out of Hospital Immediate PostpartumStandardization of out of hospital birth forms for the midwifery program.Nov 27, 2023primary-health-careclinical forms
CLI.6110.FORM.006Out of Hospital Labour RecordStandardization of out of hospital birth forms for the midwifery program.Nov 27, 2023primary-health-careclinical forms
CLI.6110.FORM.005Out of Hospital Newborn Care MapStandardization of out of hospital birth forms for the midwifery program.Nov 27, 2023primary-health-careclinical forms
CLI.4110.PL.012.FORM.01Facility Abuse Reporting FormRevised to reflect reporting questions Form was created to provide site staff with a pay to capture event information when PPCO on line reporting is not available.Nov 24, 2023across-care-areasclinical forms
CLI.6410.PL.005.FORM.04Requisition Form for Dysphagia Swallowing TEST TRAYUpdate to Screening form and new practices being implementedNov 8, 2023personal-care-homeclinical forms
CLI.6410.PL.005.FORM.05Requisition Form for Dysphagia Swallowing – Staff EducationUpdate to Screening form and new practices being implementedNov 8, 2023personal-care-homeclinical forms
CLI.6410.PL.005.FORM.01TTMD R Test of Texture Modified DietsUpdate to Screening form and new practices being implementedNov 8, 2023personal-care-homeclinical forms
ORG.1010.SG.005.SD.01Regional Education and Required Courses GuidelinesTo provide all staff with clear and consistent information and guidelines related to required education and courses.Nov 7, 2023administrationorganizational
ORG.1010.SG.005Regional Education and Required CoursesTo provide all staff with clear and consistent information and guidelines related to required education and courses.Nov 7, 2023administrationorganizational
CLI.6310.SG.016Referral Prioritization for Personal Care Home Rehabilitation Services OT PT and SLPNew guideline to prioritize referrals to the PCH'sOct 27, 2023rehabilitation-therapy-servicesclinical
CLI.5110.SG.013.SD.02CIWA Ar Screening Tool for Assessment of Patient with Alcohol WithdrawalOct 17, 2023critical-care-er-observation-scuclinical
CLI.4510.PL.009.SD.01Communication Whiteboard in Acute CareUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.009.SD.03Communication Whiteboard for ObstetricsUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.009.FORM.01Communication Whiteboard in Acute Care AuditUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.009Communication Whiteboard in Acute CareUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.009.FORM.02Communication Whiteboard for Obstetrics AuditUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.009.SD.04Communication Whiteboard for Obstetrics MockupUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.009.SD.02Communication Whiteboard in Acute Care MockupUpdate to the Communication Whiteboards in Acute Care policy to include What Matters to You section and to integrate Obstetrics; removal of whiteboard pictures from policy (converted into SDs) and introduction of "mock-up" SDs as teaching tools.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.001.FORM.05Falls Precautions Acute Care Kardex InsertUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.001Falls Prevention Acute CareUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical
CLI.4510.PL.001.FORM.03Falls Prevention Audit Emergency Observation Ambulatory Dialysis Same Day Surgery CancerCareUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.001.FORM.04Falls Prevention Audit InpatientsUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.001.FORM.02Falls Risk Assessment and Interventions for InpatientsUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.001.FORM.01Falls Risk Assessment for Ambulatory Care Dialysis Same Day Surgery CancerCareUpdated format and content; provide clarity for completion based on feedback received from Nurses, sites and Staff Educators. Updated to reflect Accreditation Standards and HIROC recommendations.Oct 17, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005.FORM.05Information Transfer Acute Care Audit for Handover of CareTo incorporate/standardize the hospital discharge plan as all sites had their own.Oct 13, 2023across-hospital-unitsclinical
CLI.4510.PL.005.FORM.02SBAR Clinical Acute CareOct 13, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005.FORM.01Hospital Discharge Instruction PlanRevision to the policy to incorporate/standardize the hospital discharge plan - sites used to have their on.Oct 13, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005.FORM.06Information Transfer Acute Care Audit for DischargesTo incorporate/standardize the hospital discharge plan as all sites had their own.Oct 13, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005.FORM.04Information Transfer Acute Care Audit for Interfacility TransfersTo incorporate/standardize the hospital discharge plan as all site had their own.Oct 13, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005.FORM.03Information Transfer Acute Care Audit for Internal TransfersTo incorporate/standardize the hospital discharge instruction plan as each site had their own.Oct 13, 2023across-hospital-unitsclinical forms
CLI.4510.PL.005Information Transfer at Care Transition Acute CareOct 13, 2023across-hospital-unitsclinical
ORG.1810.PL.009.FORM.01Prospective Analysis InvitationFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023quality-planning-and-performanceforms organizational
ORG.1810.PL.009.FORM.03Prospective Analysis Executive SummaryFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023quality-planning-and-performanceforms organizational
ORG.1810.PL.009Prospective AnalysisFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.009.SD.01Prospective Analysis Checklistrevised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023quality-planning-and-performanceorganizational
ORG.1313.PL.001.FORM.01Equipment Authorization FormChange of submission nameOct 10, 2023financecapital forms organizational
ORG.1110.PL.012.FORM.01Social Media submission formOct 5, 2023communicationsforms organizational
ORG.1912.PL.006.SD.01Catering Price ListOct 3, 2023support-servicesfood-services organizational
CLI.4510.PL.008Patient Handbooks in Acute CarePatient Info handbook template as the current version did not meet accessibility standardsSep 28, 2023across-hospital-unitsclinical
CLI.6010.PL.020.SD.01Opioid Agonist Therapy Policy HighlightsChange titles from Antagonist to Agonist on all documents.Sep 25, 2023pharmacyclinical
CLI.6010.PL.020Opioid Agonist TherapyChange titles from Antagonist to Agonist on all documents.Sep 25, 2023pharmacyclinical
CLI.6210.PL.001.SD.02Contraceptive CoverageThe supporting documents (Contraceptive guideline, reproductive supplies request form, and contraceptive coverage) were updated to removed products that have been discontinued by the manufacturers, update acquisition costs, and add a new product, Nexplanon.Sep 19, 2023public-health-healthy-livingclinical
CLI.6210.PL.001.SD.01Contraceptive Guideline and FormularyThe supporting documents (Contraceptive guideline, reproductive supplies request form, and contraceptive coverage) were updated to removed products that have been discontinued by the manufacturers, update acquisition costs, and add a new product, Nexplanon.Sep 19, 2023public-health-healthy-livingclinical
CLI.6210.PL.001.FORM.04Reproductive Supplies Stock Request FormReflects drug contract changeSep 19, 2023public-health-healthy-livingclinical forms
CLI.6210.PL.001.FORM.05Reproductive Supplies Prescription RequestRemoved products that have been discontinued by the manufacturers, update acquisition costs and add a new product, Nexplanon.Sep 19, 2023public-health-healthy-livingclinical forms
CLI.6010.SG.004.FORM.01Heparin Infusion Standard Orders VTE PECurrent standard guideline limits heparin infusions to regional sites with 24/7 lab access on site Community sites may want to start a heparin infusion prior to sending the patient out to higher level of care in order to prevent delays in treatmentSep 11, 2023pharmacyclinical forms standard-order
CLI.6010.SG.011.SD.01Discharge Information After Methotrexate for Ectopic PregnancySep 5, 2023pharmacyclinical
CLI.6010.SG.011Ectopic Pregnancy Medical and Expectant Management GuidelineSep 5, 2023pharmacyclinical
CLI.6010.SG.011.FORM.01Ectopic Pregnancy Methotrexate Standard OrdersSep 5, 2023pharmacyclinical forms standard-order
CLI.6010.SG.011.SD.02Methotrexate Treatment for Ectopic Pregnancy Patient InformationSep 5, 2023pharmacyclinical
CLI.6010.FORM.001PCH Medication Standing OrdersSep 4, 2023pharmacyclinical forms standard-order
ORG.1010.PL.002.FORM.01Language Access Interpreter Services Request Confirmation CancellationSep 1, 2023administrationforms organizational
CLI.6010.PL.009.FORM.04Home Care Best Possible Medication History and Physician ConfirmationChanged the SD to a FORM - new policy guidelinesAug 31, 2023pharmacyclinical forms
CLI.6010.FORM.006Adult Bowel Movement Standard Orders for Acute CareAddition of MAR examplesAug 31, 2023pharmacyclinical forms standard-order
CLI.6010.PL.009.FORM.01Best Possible Medication History BPMH and Admission Reconciliation and Order FormAug 31, 2023pharmacyclinical forms
CLI.6010.PL.009Medication ReconciliationAug 31, 2023pharmacyclinical
CLI.6010.PL.009.SD.01Medication Reconciliation Quick Reference GuideAug 31, 2023pharmacyclinical
CLI.4510.SG.007.SD.02Telemetry Flowsheet Record Directions for UseCreated to support practices at regional sites. All 3 sites participated in a trial to test the guidelines/forms.Aug 28, 2023across-hospital-unitsclinical
CLI.4510.SG.007.FORM.02Telemetry Flowsheetto support practices at regional sites. All 3 sites participated in a trial to test the guideline/formsAug 28, 2023across-hospital-unitsclinical forms
CLI.4510.SG.007.SD.03Telemetry Kardex Directions for UseCreated to support practices at regional sites. All 3 sites participated in a trial to test the guidelines/forms.Aug 28, 2023across-hospital-unitsclinical
CLI.4510.SG.007.FORM.03Telemetry KardexCreated to support practices at regional sites. All 3 sites participated in a trial to test the guideline/formsAug 28, 2023across-hospital-unitsclinical forms
CLI.4510.SG.007.SD.01Electrode Placement for Inpatient TelemetryCreated to support practices at regional sites. All 3 sites participated in a trial to test guidelines/forms.Aug 28, 2023across-hospital-unitsclinical
CLI.4510.SG.007.FORM.01Inpatient Telemetry Standard OrdersCreated to support practices at regional sites. All 3 sites participated in a trial to test the guideline/formsAug 28, 2023across-hospital-unitsclinical forms
CLI.4510.SG.007Inpatient TelemetryCreated to support practices at regional sites. All 3 sites participated in a trial to test the guideline/forms.Aug 28, 2023across-hospital-unitsclinical
CLI.6010.FORM.012Medication Room Audit Acute CareAug 25, 2023pharmacyclinical forms
CLI.6010.FORM.013Medication Room Audit Personal Care Home1. Fridge temperature is maintained between 2-8ï‚°C. 2. Medication fridge temperature is recorded at least once daily. 3. added "pareneral items" route for questions #37 & #38Aug 25, 2023pharmacyclinical forms
CLI.5810.FORM.004Cesarean Section Perinatal Loss Care MapUpdated list of forms and language to be inclusiveAug 21, 2023obstetricsclinical forms
CLI.5810.FORM.081Cesarean Section Perinatal Loss Record of Postpartum Patient LearningUpdated language to be inclusiveAug 21, 2023obstetricsclinical forms
CLI.5810.FORM.075Standard Orders Maternal Neonatal DeathUpdated - Standard Orders, investigations to reflect the changes in Shared Health Lab requisitions and forms, Sexually transmitted and bloodborne infections panel are clearly separately identified to decrease the chance of overlooking a test.Aug 21, 2023obstetricsclinical forms standard-order
CLI.5810.FORM.069Standard Orders Maternal StillbirthUpdated Standard Orders, identified updated investigations and included Sexually transmitted and bloodborne infections -written individually, not in a panel to avoid missing a testAug 21, 2023obstetricsclinical forms standard-order
CLI.5810.FORM.070Standard Orders Spontaneous AbortionAug 21, 2023obstetricsclinical forms standard-order
CLI.5810.FORM.082Loss of Your Baby Release Form BilingualRemoved section "C" from previous form as regional funeral homes have now incorporated cremation and burial ceremonies within the region. If families choose to have the infant cremated in Winnipeg, the regional funeral homes will arrange this. Added "C" that the family will contact a funeral home to review all options available for cremation or burial. Wording changed to be inclusive from "I" and "me" to "We" and "Our"Aug 21, 2023obstetricsclinical forms
CLI.5810.FORM.083Perinatal Loss Communication ChecklistDocument is used as a "worksheet" for staff while completing documentation and is meant to be shredded after completed and is not part of the patient record. This checklist has been updated to include the SharedHealth forms and processesAug 21, 2023obstetricsclinical forms
CLI.5810.FORM.011Postpartum Perinatal Loss Care MapUpdated list of forms and language to be inclusiveAug 21, 2023obstetricsclinical forms
CLI.5810.FORM.078Standard Orders Fetal Neonatal DeathUpdated - Standard Orders, investigations to reflect the changes in Shared Health Lab requisitions and forms. Forms are clearly stated on general orders. General orders are clear and precise for staff to understand easily.Aug 21, 2023obstetricsclinical forms standard-order
CLI.6010.PL.009.FORM.06Addendum Therapeutic Substitution Order from PharmacyAug 21, 2023pharmacyclinical forms
CLI.6010.PL.046.FORM.02Postpartum Medication Self Medication RecordThe current policy does not have specific instructions for obstetrics. Need to add post partum specific pain medications to the policy list. Added post partum medication self-administration record. Updated corresponding standard orders and MARs.Aug 17, 2023pharmacyclinical forms
CLI.6010.PL.046Medication Self AdministrationCurrent policy does not have specific instructions for obstetrics. Need to add post partum self-administration pain medications to the policy list. Also need a post partum medication self-administration record. To provide guidance to staff regarding self-administration of medications by patients.Aug 17, 2023pharmacyclinical
CLI.6010.PL.046.FORM.01Medication Self Administration RecordTo provide guidance to staff regarding self-administration of medications by patients. Changed from an SD to a FormAug 17, 2023pharmacyclinical forms
CLI.6210.SG.008.FORM.03Administration of Rabies Immune Globulin and Rabies Vaccine Fax TemplateAug 16, 2023public-health-healthy-livingclinical forms
CLI.6010.PL.010Telephone or Verbal OrdersUpdated policy to include community programs i.e. home care, palliative care, mental health & My Health Team. Also, reinforce thal ALL medication orders MUST be signed by prescriber.Aug 16, 2023pharmacyclinical
ORG.1810.PL.009.FORM.02Prospective Analysis TemplateFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Aug 11, 2023quality-planning-and-performanceforms organizational
CLI.4110.PL.027.SD.01Catheter to Vessel Ratio for Peripherally InsertedAug 10, 2023across-care-areasclinical
CLI.4110.PL.015.FORM.01Safe Medication Administration Audit Acute CareReflect current practices with Elsevier; to incorporate the changes related to the B. Braun IV pumps, Accreditation Standards, auditing processAug 10, 2023across-care-areasclinical forms
CLI.4110.PL.015.FORM.02Safe Medication Administration Audit Summary Acute CareRevisions to reflect current practices with Elsevier, incorporate changes related to B. Braun IV pumps and Accreditation Standards and to provide clarity on the auditing process and number of audits required per unit/service area.Aug 10, 2023across-care-areasclinical forms
CLI.4110.PL.027.SD.02.FUltrasound Guided Intravenous Insertion – Teaching Sheet- FrenchNew clinical procedure implemented in region. Formal documentation developed to support clinical staff performing procedure.Aug 10, 2023across-care-areasclinical
CLI.4110.PL.027.SD.02Ultrasound Guided Intravenous Insertion Teaching SheetNew clinical procedure implemented in region. Formal documentation developed to support clinical staff performing procedure.Aug 10, 2023across-care-areasclinical
CLI.4110.PL.027.FORM.01Ultrasound Guided Peripheral Intravenous Insertion LogNew clinical procedure implemented in region. Formal documentation developed to support clinical staff performing procedure.Aug 10, 2023across-care-areasclinical forms
CLI.4110.PL.027.FORM.02Ultrasound Guided Peripheral Intravenous Procedure ChecklistNew clinical procedure implemented in region. Formal documentation developed to support clinical staff performing procedure.Aug 10, 2023across-care-areasclinical forms
CLI.6010.PL.073.FORM.01Investigated Information for Transport Medications Involved in a Temperature ExcursionCurrently communication when transporting medications from pharmacy or for monitoring temperature of refrigerated medications is fragmented. A Regional process will minimize errors and temperature excursions.Aug 10, 2023pharmacyclinical forms
CLI.6010.PL.004.FORM.01Antimicrobial Stewardship Feedback FormTo be used as a communication tool for pharmacists/prescribersAug 10, 2023pharmacyclinical forms
CLI.6010.PL.004Antibiotic Stewardship ProgramAug 10, 2023pharmacyclinical
CLI.6010.PL.073.SD.01Cold Temperature 8 Degrees Temperature Reading GuidelineAug 10, 2023pharmacyclinical
CLI.6010.PL.073.SD.02Pharmacy Process for Transport Temperature ExcursionCurrently communication when transporting medications from pharmacy or for monitoring temperature of refrigerated medications is fragmented. A Regional process will minimize errors and temperature excursions.Aug 10, 2023pharmacyclinical
CLI.6010.PL.073.SD.03Transport of Hazardous Medication by Deliver Services Driver Safety PamphletCurrently communication when transporting medications from pharmacy or for monitoring temperature of refrigerated medications is fragmented. A Regional process will minimize errors and temperature excursions.Aug 10, 2023pharmacyclinical
CLI.6010.PL.073Packaging and Transport of Pharamceuticals Facility to FacilityCurrently communication when transporting medications from pharmacy or for monitoring temperature of refrigerated medications is fragmented. A Regional process will minimize errors and temperature excursions.Aug 10, 2023pharmacyclinical
CLI.6010.FORM.016Patient Controlled Analgesic PCA and Assessment Flow SheetCurrently the PCA pump process is different at each site, the process has been regionalized to include preparation of medication, administration, prescribing, assessment flowsheet, updated parenteral monographs for HYDROmorphone PCA & morphine PCA.Aug 10, 2023pharmacyclinical forms
CLI.6310.SG.005Referral Prioritization Waitlist Management for Outpatient OT PT and SLP Children and Youth Services pdfStandardize OT, PT and SLP referral prioritization and waitlist management for children and youth servicesAug 9, 2023rehabilitation-therapy-servicesclinical
CLI.6010.PL.074Receipt Storage and Internal Transport of PharmaceuticalsComplements the Packaging and Transport of Pharmaceuticals Facility to Facility policyAug 9, 2023pharmacyclinical
CLI.6010.PL.074.FORM.01Medication Transportation Cover LetterAug 9, 2023pharmacyclinical forms
CLI.6310.SG.003Referral Prioritization for Audiology ServicesCLI.6310.SG.001.FORM.01 name change from Rehab Services Children and Youth Referral Form to Southern Children's Therapy Network of Manitoba Referral Form and CLI.6310.SG.003.SD.01 has name change from Children's Therapy Initiative (CTI) to Children's Therapy Network of Manitoba (CTNM)Aug 4, 2023rehabilitation-therapy-servicesclinical
CLI.6310.SG.003.SD.01Childrens Therapy Network of Manitoba Priority Rating Scale AudiologyName changed from Children's Therapy Initiative (CTI) to Children's Therapy Network of Manitoba (CTNM)Aug 4, 2023rehabilitation-therapy-servicesclinical
CLI.6310.SG.005.SD.01Childrens Therapy Initiative CTI Network Priority Ratings Occupational TherapyName changed from Children's Therapy Initiative (CTI) to Children's Therapy Network of Manitoba (CTNM)Aug 4, 2023rehabilitation-therapy-servicesclinical
CLI.6310.SG.005.SD.02Childrens Therapy Network of Manitoba Priority Ratings PhysiotherapyName changed from Children's Therapy Initiative (CTI) to Children's Therapy Network of Manitoba (CTNM)Aug 4, 2023rehabilitation-therapy-servicesclinical
CLI.6310.SG.005.SD.03Childrens Therapy Network of Manitoba Priority Ratings Speech Language PathologyName changed from Children's Therapy Initiative (CTI) to Children's Therapy Network of Manitoba (CTNM)Aug 4, 2023rehabilitation-therapy-servicesclinical
CLI.6310.SG.012School Division Referral Prioritization for OT and PTName change from Rehab Services Children and Youth Referral Form to Southern Children's Therapy Network of ManitobaAug 4, 2023rehabilitation-therapy-servicesclinical
File Summary FormAug 3, 2023human-resourcesforms workplace-safety-and-health
CLI.4510.PR.002.FORM.11Fluid Balance Record 8 HoursHarmonized chart documentation forms improves the quality of the forms within the Acute Care health records and consistency in documentation practices that promotes safer patient care.Jul 31, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.12Fluid Balance Record 12 HourHarmonized chart documentation forms improves the quality of the forms within the Acute Care health records and consistency in documentation practices that promotes safer patient care.Jul 31, 2023across-hospital-unitsclinical forms
CLI.6010.PR.002.SD.01Handling of Multi Dose Vial ExceptionsRemoved acetylcysteine from the exception list. The product monograph states that opened vials for IV use are single use only.Jul 26, 2023pharmacyclinical
CLI.6010.FORM.015Adult Diabetic Ketoacidosis DKA Hyperosmolar Hyperglycemia State HHS Standard OrdersTo regionalize the DKA/HHS process and orders for ALL sitesJul 26, 2023pharmacyclinical forms standard-order
CLI.6010.SG.008Dissolve and DoseAdding a supporting document to the Dissolve and Dose guideline including instructions for Misoprostol utilized in labour inductionJul 26, 2023pharmacyclinical
CLI.6010.FORM.017Smoking Cessation Standard OrdersReplacement therapy for tobacco smokers.Jul 26, 2023pharmacyclinical forms standard-order
CLI.6010.FORM.002Subcutaneous Insulin Correction Standard OrdersUpdating confusing wording regarding on how to assess patient.Jul 26, 2023pharmacyclinical forms standard-order
CLI.6010.PL.019Take Home Naloxone ProgramAdded Answer Key to Post Training Questionnaire.Jul 26, 2023pharmacyclinical
CLI.6010.PL.019.SD.04THN Program Post Training Questionnaire Answer KeyAdded Answer Key to Post Training Questionnaire.Jul 26, 2023pharmacyclinical
CLI.6010.SG.008.SD.04Misoprostol Dissolve and Dose InstructionsAdding a supporting document to the Dissolve and Dose guideline including instructions for Misoprostol utilized in labour induction.Jul 26, 2023pharmacyclinical forms
CLI.6010.SG.004Anticoagulation for Venous ThromboembolismJul 25, 2023pharmacyclinical
CLI.6010.SG.004.FORM.02Dalteparin Standard Orders VTECurrent standard guideline limits heparin infusions to regional sites with 24/7 lab access on site. Community sites may want to start a heparin infusion prior to sending the patient out to higher level of care in order to prevent delays in treatment.Jul 25, 2023pharmacyclinical forms
CLI.4510.PL.001.SD.01Falls and You Most Falls are PreventableJul 14, 2023across-hospital-unitsclinical
CLI.5810.FORM.054Standard Orders Newborn CareBest Practice update including: Phytonadione (vitamin K) 2mg orally; Erythromycin 0.5% ophthalmic ointment and Best Practice updates.Jul 10, 2023obstetricsclinical forms standard-order
CLI.4110.PL.012Freedom from Abuse or Neglect of Patients and Residents in a Health Care FacilityRevisions made to policy because of change to on line reportingJul 6, 2023across-care-areasclinical
ORG.1710.PL.003Tenders and QuotationsJul 5, 2023logistics-and-supply-chain-managementorganizational
QHR_SignIn_Electronic Submission Template Reserved ActsJul 1, 2023human-resourcesforms
CLI.4510.SG.001.SD.01Risk Assessment and Venous Thromboemolism VTE Prophylaxis RecommendationsJun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.006.FORM.01Safe Blood and Blood Products Administration AuditJun 21, 2023across-hospital-unitsclinical forms
CLI.4510.PL.004.FORM.01Screening and Alert for Violence and Aggression Acute CareJun 21, 2023across-hospital-unitsclinical forms
CLI.4510.PL.006.SD.01Transfusion of Blood and Blood Products AlgorithmUpdated due to changes to Transfusion Medicine and the shift from binders at the sites to accessing the documents electronically.Jun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.006Transfusion of Blood and Blood ProductsReplacing with the updated Best Blood Manitoba Transfusion Best Practice Resource Manual to identify best practices for safe administration of blood and blood products. Policy was updated due to changes to Transfusion Medicine and the shift from binders at the sites to accessing the documents electronically. As part of the revision, we have added the teaching sheet as a supporting document.Jun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.012Vascular Access AssessmentNew overarching policy to provide formal direction on vascular access treatment therapies.Jun 21, 2023across-hospital-unitsclinical
CLI.4510.SG.001Venous Thromboembolism VTE Prophylaxis GuidelineMoved from Critical Care Section to Across Hospital Units section - renumberd to reflect change, links to supporting documents/forms also updated to reflect change and HPS. Changes to language to be consistent, updated the do not use abbreviation section and new additions based on Accreditation Standards.Jun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.004.FORM.02Violence Prevention Program Care Plan Guide Acute CareAs part of the violence prevention program (VPP) province-wide initiative and congruent with Southern Health-Santé Sud ‘s Violence Prevention Program for Health Care Workers (ORG.1513.PL.001), this policy provides a standardized approach to screening patients at risk for violent or aggressive behavior in all acute care sites in Southern Health-Santé Sud.Jun 21, 2023across-hospital-unitsclinical forms
CLI.4510.PL.004.FORM.03Violence Prevention Program in Acute Care AuditLanguage to have consistency with patient vs patient/client used interchangeably.Jun 21, 2023across-hospital-unitsclinical forms
CLI.4510.PL.004.SD.03Violence Prevention Program Use CARE Environment Alert Door HangerJun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.004.SD.02Violence Prevention Program Use CARE Environment Alert Acute CareJun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.004.SD.01Violence Prevention Program in Acute Care Screening for Violence or Aggression AlgorithmJun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.004Violence Prevention Program in Acute CareJun 21, 2023across-hospital-unitsclinical
CLI.4510.SG.001.SD.02Clot Prevention Venous Thromboembolism ProphylaxisJun 21, 2023across-hospital-unitsclinical
CLI.4510.PL.006.SD.02After Receiving a Blood Product Patient Teaching HandoutJun 21, 2023across-hospital-unitsclient-teaching-handouts clinical
ORG.1910.SG.001Cleaning after Construction Renovation and MaintenanceJun 20, 2023support-serviceshousekeeping organizational
CLI.4110.PL.004.SD.02.FPeripherally Inserted Central Catheter Teaching Sheet – FrenchUpdated based on best practice evidence, the most current guidelines and policies from the Canadian Vascular Access Association (CVAA) and Infusion Nurses Society (INS) as well as input from vascular access subject matter experts (SMEs).CLI.4110.PL.004.FORM.01 - Alteplase (Cathflo®) Standard Order- to be discontinued and archived.Jun 9, 2023across-care-areasclinical
CLI.4110.PL.004.SD.02Peripherally Inserted Central Catheter Teaching SheetUpdated based on best practice evidence, the most current guidelines and policies from the Canadian Vascular Access Association (CVAA) and Infusion Nurses Society (INS) as well as input from vascular access subject matter experts (SMEs).CLI.4110.PL.004.FORM.01 - Alteplase (Cathflo®) Standard Order- to be discontinued and archived.Jun 9, 2023across-care-areasclinical
CLI.6310.PL.002.FORM.02Rehabilitation Services PCH OT Wait ListJun 2, 2023rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.002.FORM.03Rehabilitation Services PCH PT Wait ListJun 2, 2023rehabilitation-therapy-servicesclinical forms
CLI.6310.PL.002.FORM.04Rehabilitation Services PCH SLP Wait ListJun 2, 2023rehabilitation-therapy-servicesclinical forms
CLI.4511.PL.012Systemic Therapy Privileges for CancerCare Manitoba CCMB for Physicians in Southern Health-Santé SudMay 25, 2023across-hospital-unitscancer-care-hub clinical
CLI.5810.FORM.063Standard Orders Post Cesarean SectionMay 17, 2023obstetricsclinical forms standard-order
CLI.5810.FORM.057Standard Orders Postpartum Vaginal DeliveryMay 17, 2023obstetricsclinical forms standard-order
CLI.5810.FORM.060Standard Orders Pre Op Cesarean SectionMay 17, 2023obstetricsclinical forms standard-order
CLI.4110.PL.001.SD.01Consent for Procedures Treatments or Investigations ListMay 16, 2023across-care-areasclinical
CLI.4110.PL.001.FORM.01Consent to Procedure Treatment or Investigation BilingualMay 16, 2023across-care-areasclinical forms
CLI.4110.PL.001.FORM.02Minors Rights to Demonstrate Capacity for Health Care Decision MakingMay 16, 2023across-care-areasclinical forms
CLI.4110.PL.001.FORM.04Governing Law and Jurisdiction AgreementMay 16, 2023across-care-areasclinical forms
CLI.4110.PL.001.FORM.05Surgical Consent Documentation Audit templateMay 16, 2023across-care-areasclinical forms
ORG.1810.PL.001.SD.01Safety Event Report Resource GuideMay 10, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.001Safety Event ReportingMay 10, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.001.SD.04Management of a Critical Occurrence ChecklistMay 10, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.001.SD.03Management of a Critical Incident ChecklistMay 10, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.001.SD.02Management of a Near Miss and Occurrence ChecklistMay 10, 2023quality-planning-and-performanceorganizational
CLI.8011.PL.021Additional Precautions PolicyMay 5, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.021.SD.01Additional Precautions posterMay 5, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.021.SD.01.FAdditional precautions poster – FrenchMay 5, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6611.FORM.004Breast Surgery Pre Operative ChecklistMay 5, 2023perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.SG.002Dress Code and General Conduct in the Perioperative EnvironmentMay 5, 2023perioperativeclinical surgical-unit-same-day-surgery
CLI.5810.SG.002Fetal Health Surveillance in LabourProvincial Clinical Guideline provided by Shared HealthMay 4, 2023obstetricsclinical
CLI.6010.FORM.011Pertussis Whooping Cough Treatment Standard OrdersMay 4, 2023pharmacyclinical forms standard-order
ORG.1010.PL.001.FORM.01Notification of Suspension of Services FormMay 3, 2023administrationforms organizational
ORG.1110.PL.003.SD.02Media Calls Techniques TipsApr 28, 2023communicationsorganizational
ORG.1010.PL.002Interpreter Services Language AccessApr 27, 2023administrationorganizational
ORG.1010.PL.002.SD.02Tips for Working with Professional InterpretersApr 27, 2023administrationorganizational
CLI.8011.PL.017Clostridioides Difficile Infection CDI ManagementApr 24, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.4510.PR.002.SD.11Fluid Balance Record 8 Hours DirectionsApr 14, 2023across-hospital-unitsclinical
CLI.4510.PR.002.SD.12Fluid Balance Record 12 Hour DirectionsApr 14, 2023across-hospital-unitsclinical
ORG.1410.PL.551Staff Witness to Legal DocumentsApr 13, 2023health-information-serviceshealth-information organizational
ORG.1010.FORM.004Agenda TemplateApr 4, 2023administrationforms organizational
ORG.1010.FORM.005Minutes TemplateApr 4, 2023administrationforms organizational
CLI.6010.PL.019.FORM.08THN Program Post Training QuestionnaireApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.07THN Program Intake FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.06Overdose Response FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.05THN Kit Distribution LogApr 1, 2023pharmacyclinical
CLI.6010.PL.019.FORM.04THN Kit Tracking FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.03New Provider Application FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.02THN Kit Order FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.FORM.01THN Distribution Site Agreement FormApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.SD.03Patient Handout Naloxone Injection Training ChecklistApr 1, 2023pharmacyclinical forms
CLI.6010.PL.019.SD.02Patient Handout What is naloxone and why do you need itApr 1, 2023pharmacyclinical
CLI.6010.PL.019.SD.01Training Manual Overdose Prevention Recognition and ResponseApr 1, 2023pharmacyclinical
CLI.6010.PL.019.FORM.09THN Program Overdose Recognition and Response Training RecordApr 1, 2023pharmacyclinical forms
CLI.5610.PL.002.SD.01Triage Scale Community Mental HealthMar 30, 2023mental-health-and-addictionsclinical
ORG.1810.PL.010.SD.01Management of a Serious Adverse Drug Reactions and Medical Device Incidents ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.SG.004.SD.01Duty to Warn Guideline ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.SG.004Duty to Warn GuidelineMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.SG.004.FORM.01Duty to Warn Guideline FormMar 27, 2023quality-planning-and-performanceforms organizational
ORG.1810.PL.010.SD.03Management of a Gunshot and Stab Wound ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.010.SD.02Management of an Adverse Event Following Immunization ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.010.SD.06Management of a Sexually Transmitted and Blood Borne Infection ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.010.SD.04Management of Suspected Adult Abuse and Neglect ChecklistMar 27, 2023quality-planning-and-performanceorganizational
ORG.1810.PL.010.SD.05Management of Suspected Child Abuse and Neglect ChecklistMar 27, 2023quality-planning-and-performanceorganizational
CLI.6410.PL.017.SD.01PCH Client information Handbook Regional PCH FSP regionaux InfoMar 26, 2023personal-care-homeclinical
CLI.4510.PR.002.FORM.07Patient Assessment FlowsheetMar 21, 2023across-hospital-unitsclinical forms
CLI.6310.FORM.001Rehabilitation Services Physiotherapy Vestibular AssessmentMar 16, 2023rehabilitation-therapy-servicesclinical forms
CLI.6410.PR.003.FORM.01Community Bathing Program ApplicationMar 15, 2023personal-care-homeclinical forms
CLI.6410.PR.003Community Bathing ProgramMar 15, 2023personal-care-homeclinical
CLI.6410.PL.026Oxygen Therapy in Personal Care HomesMar 15, 2023personal-care-homeclinical
CLI.6410.PL.025Discharge to Community from PCH SettingMar 13, 2023personal-care-homeclinical
ORG.1110.FORM.012PowerPoint Presentation IIIMar 8, 2023communicationsforms organizational
ORG.1110.FORM.011PowerPoint Presentation IIMar 8, 2023communicationsforms organizational
ORG.1110.FORM.002Letterhead TemplateMar 8, 2023communicationsforms organizational
ORG.1110.FORM.013With Compliments Slip TemplateMar 3, 2023communicationsforms organizational
ORG.1110.FORM.010PowerPoint Presentation IMar 3, 2023communicationsforms organizational
ORG.1110.FORM.009Poster Template IIMar 3, 2023communicationsforms organizational
ORG.1110.FORM.005Interior Door Signage TemplateMar 3, 2023communicationsforms organizational
CLI.5411.PL.010Nursing Service DeliveryFeb 27, 2023home-careclinical
CLI.5411.PL.010.SD.01Nursing Service Delivery Info SheetFeb 27, 2023home-careclinical service-delivery
CLI.5412.PL.01.SD.01HC Wound Photography Flow ChartFeb 22, 2023home-careclinical nursing
CLI.5412.PL.001Wound Care Management by Client CaregiverFeb 22, 2023home-careclinical nursing
CLI.5411.PL.011.FORM.01Seating Cushions Covers Client InfoFeb 21, 2023home-careclinical forms service-delivery
CLI.5410.SG.001.SD.01Home Care Alternate Access to HomeFeb 21, 2023home-careaccess clinical forms
CLI.5410.SG.001Alternate Access to HomeFeb 21, 2023home-careaccess clinical
CLI.5411.PL.011Seating Cushions CoversFeb 21, 2023home-careclinical service-delivery
ORG 1410.PL.001.SD.02Client Chart Health Record Order Home Care NursingFeb 16, 2023health-information-servicesforms health-information organizational
CLI.8011.PL.020.SD.03Doffing PPE posterFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.020.SD.03.FDoffing PPE poster – FrenchFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.020.SD.02Donning PPE posterFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.020.SD.02.FDonning PPE poster – FrenchFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.020Routine PracticesFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.020.SD.01Point of Care Risk Assessment PCRAFeb 14, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.007.FORM.01Oseltamivir Dosage Calculation ChartFeb 13, 2023infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
ORG.1912.PL.005.FORM.04Food Temperature RecordFeb 13, 2023support-servicesfood-services forms organizational
CLI.6410.PL.023.SD.02Guideline for Charge Licensed Practical Nurse in Personal Care HomeJan 18, 2023personal-care-homeclinical
CLI.6410.PL.023.SD.01Nursing Services Under Leadership of the LPN_Decision Making Flow ChartJan 18, 2023personal-care-homeclinical
CLI.6410.PL.023Nursing Services Under the Leadership of Licensed Practical Nurse in Personal Care HomesJan 18, 2023personal-care-homeclinical
CLI.6410.PR.002Ointment Creams and Medicated Shampoo Application by HCAJan 18, 2023personal-care-homeclinical
ORG.1010.PL.005.FORM.05Archive Notice TemplateJan 18, 2023administrationforms organizational
CLI.8011.PL.019.FORM.04Memorandum for SurgeonsJan 16, 2023infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019Surgical Site Infection SSI SurveillanceJan 16, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.FORM.02Surgical Site Infection Data Collection FormJan 16, 2023infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.FORM.01Surgical Site Infection Report FormJan 16, 2023infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.SD.01Surgical Wound Classification TableJan 16, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.SD.02.FPatient Fact Sheet Preventing Surgical Site Infections – FrenchJan 16, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.SD.02Patient Fact Sheet Preventing Surgical Site InfectionsJan 16, 2023infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.019.FORM.03Postoperative SSI Surveillance Telephone ScriptJan 16, 2023infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.4510.PR.002.SD.04Neurological Assessment Record Acute Care DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.FORM.04Neurological Assessment Record Acute CareJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.07Patient Assessment Flowsheet DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.SD.13Prescriber Order Sheet DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.SD.05Signature Record DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.FORM.05Signature RecordJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.06Clinical Record DirectionsHarmonized chart documentation forms improves the quality of the forms within the Acute Care health records and consistency in documentation practices that promotes safer patient care.Jan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.FORM.06Clinical RecordJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.03Cardiac Rhythm Strip Record DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.FORM.03Cardiac Rhythm Strip RecordJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.02Frequent Monitoring Record DirectionsJan 16, 2023across-hospital-unitsclinical
CLI.4510.PR.002.FORM.02Frequent Monitoring RecordJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.FORM.01Integrated Progress NotesJan 16, 2023across-hospital-unitsclinical forms
CLI.4510.PR.002.SD.01Integrated Progress Notes DirectionsJan 16, 2023across-hospital-unitsclinical
ORG.1410.PL.302Health Record Management in the Event of an EvacuationJan 13, 2023health-information-serviceshealth-information organizational
CLI.6611.FORM.003Operating Room Logging RecordJan 11, 2023perioperativeclinical forms surgical-unit-same-day-surgery
ORG.1710.PL.006Disposal of Capital EquipmentJan 11, 2023logistics-and-supply-chain-managementorganizational
ORG.1910.PR.060Decanting Bulk Chemical ProductsJan 11, 2023support-serviceshousekeeping organizational
ORG.1411.PL.404.FORM.02Tracking Transport Confidential Information Records for Appointments FormJan 11, 2023health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.404.FORM.01Tracking of Confidential Information WorksheetJan 11, 2023health-information-servicesforms organizational privacy-and-access
ORG.1810.PL.002.FORM.01Disclosure Record to Clients Patients and FamiliesJan 5, 2023quality-planning-and-performanceforms organizational
ORG.1810.PL.002Disclosure Process Critical IncidentsJan 5, 2023quality-planning-and-performanceorganizational
ORG.1710.PL.004Exceptions to Purchasing PoliciesJan 5, 2023logistics-and-supply-chain-managementorganizational
ORG.1010.PL.002.SD.01Interpreter Services Language Access FlowchartJan 4, 2023administrationorganizational
Registration and License Expense Claim form SH-SSDec 20, 2022financeforms
CLI.6410.PL.024Hairstyling Services in Personal Care HomesDec 16, 2022personal-care-homeclinical
CLI.6410.PL.024.FORM.01Regional Memorandum of Understanding for Hairstyling ServicesDec 16, 2022personal-care-homeclinical forms
CLI.4110.PL.026.FORM.01Negative Pressure Wound Therapy NPWT Screening Tool and Standard Orders December 3 2022Dec 12, 2022across-care-areasclinical forms
CLI.4110.PL.026Negative Pressure Wound Therapy PolicyDec 12, 2022across-care-areasclinical
ORG.1810.PL.011.FORM.01Tool for Guided Learning and DiscussionDec 1, 2022quality-planning-and-performanceforms organizational
ORG.1810.PL.011Patient Safety Learning AdvisoryDec 1, 2022quality-planning-and-performanceorganizational
CLI.6310.SG.004Referral Prioritization for Outpatient Hand Therapy Occupational Therapy and PhysiotherapyNov 14, 2022rehabilitation-therapy-servicesclinical
CLI.6310.SG.002Referral Prioritization for Outpatient SLP Adults ServiceNov 2, 2022rehabilitation-therapy-servicesclinical
ORG.1410.PL.005.FORM.01Thinning of Documents From Client Charts TrackingOct 19, 2022health-information-servicesforms health-information organizational
ORG.1410.PL.005Thinning of Documents from Client Charts in Clinical Areas ProgramsOct 19, 2022health-information-serviceshealth-information organizational
ORG.1410.PL.005.SD.03Thinning of Documents from Client Charts in Clinical Area Program Guideline PCH and Transitional Care CentresOct 19, 2022health-information-serviceshealth-information organizational
ORG.1410.PL.005.SD.02Thinning of Documents from Client Charts in Clinical Area Program Guideline Home Care NursingOct 19, 2022health-information-serviceshealth-information organizational
ORG.1410.PL.005.SD.01Thinning of Documents from Client Charts in Clinical Area Program Guideline Acute CareOct 19, 2022health-information-serviceshealth-information organizational
ORG.1410.PL.001Client Chart Health Record OrderOct 19, 2022health-information-serviceshealth-information organizational
ORG 1410.PL.001.SD.04Client Chart Health Record Order PCH and Transitional Care CentresOct 19, 2022health-information-serviceshealth-information organizational
ORG.1410.PL.001.FORM.02Client Chart Health Record Order Audit Tool Home Care NursingOct 19, 2022health-information-servicesforms health-information organizational
ORG.1410.PL.001.FORM.01Client Chart Health Record Order Audit Tool Acute CareOct 19, 2022health-information-servicesforms health-information organizational
ORG.1410.PL.001.SD.01Client Chart Health Record Order Acute CareOct 19, 2022health-information-serviceshealth-information organizational
ORG.1314.FORM.011Additional Service Log Rehab ServicesOct 14, 2022human-resourcesforms organizational payroll
ORG.1411.PL.101.FORM.01.FRequest to Access Personal Health Information – FrenchOct 3, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.06.FRequest for Additional Information Template – FrenchOct 3, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.03.FRefusing a Request For Access – FrenchOct 3, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.07.FNotification of Abandoned Request Template – FrenchOct 3, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.05.FEstimate of Fees for Access to Personal Health Information Template FROct 3, 2022health-information-servicesforms organizational privacy-and-access
CLI.6310.PL.003.SD.01Clinical Decision Algorithm for Patients with TracheostomyOct 3, 2022rehabilitation-therapy-servicesclinical
CLI.6310.PL.003Tracheostomy Patient Care and Speech Language Pathology ServicesOct 3, 2022rehabilitation-therapy-servicesclinical
ORG.1411.PL.101Access to Personal Health InformationOct 3, 2022health-information-servicesorganizational privacy-and-access
ORG.1314.FORM.003Position Control Create Delete Modify FormSep 29, 2022human-resourcesforms organizational payroll
ORG.1411.PL.101.FORM.04Record Does Not Exist or Cannot Be Located TemplateSep 29, 2022health-information-servicesforms organizational privacy-and-access
CLI.6310.SG.006Referral Prioritization for Adult Outpatient PhysiotherapySep 23, 2022rehabilitation-therapy-servicesclinical
ORG.1912.PL.007.SD.01Food Choices For Balanced MealsSep 15, 2022support-servicesfood-services organizational
ORG.1912.PL.007Food Choices for Client Menu Cafeteria Vending and CateringSep 15, 2022support-servicesfood-services organizational
ORG.1912.PL.007.SD.02Food Choices For Vending and FundraisingSep 15, 2022support-servicesfood-services organizational
ORG.1912.PL.007.SD.01Food Choices ExamplesSep 15, 2022support-servicesfood-services organizational
CLI.4110.PL.024.SD.01Topical Antimicrobial Indicated in WoundsSep 9, 2022across-care-areasclinical
CLI.4110.PL.024Wound Care Prescriber OrdersSep 9, 2022across-care-areasclinical
ORG.1311.PR.001.SD.01Accounts Payable Processing GuideAug 23, 2022financeaccounts-payable organizational
CLI.6010.PL.047Medication Allergy Identification and Reaction RecordingAug 11, 2022pharmacyclinical
CLI.6010.PL.047.SD.01Clinical Circumstances SheetAug 1, 2022pharmacyclinical forms
ORG.1411.PL.203.FORM.02Reporting and Investigating Privacy Breaches and Complaints Fact finding Interview GuideJul 13, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.203Reporting and Investigating Privacy Breaches and ComplaintsJul 13, 2022health-information-servicesorganizational privacy-and-access
ORG.1411.PL.203.FORM.01Privacy Incident ReportJul 13, 2022health-information-servicesforms organizational privacy-and-access
Shipping LabelsJul 7, 2022logistics-and-supply-chain-managementforms
Work from home safety checklistJun 15, 2022human-resourcesforms labour-relations
ORG.1010.PL.001.SD.02EMS Redirection Diversion AdvisoryJun 15, 2022administrationorganizational
ORG.1010.PL.001.FORM.02Notification of Suspension of Services Form SampleJun 15, 2022administrationforms organizational
ORG.1010.PL.001Suspension of ServicesJun 14, 2022administrationorganizational
CLI.6310.SG.007CBR and Outpatient Occupational Therapy Prioritization Guidelines Adult ServicesJun 13, 2022rehabilitation-therapy-servicesclinical
Application and agreement to work from homeJun 12, 2022human-resourcesforms labour-relations
CLI.5412.SG.001.FORM.01HC Collaborative Care Team Action LogJun 12, 2022home-careclinical forms nursing
CLI.5412.SG.001.SD.01HC Collaborative Care Team Meeting Ground RulesJun 12, 2022home-careclinical nursing
CLI.5412.SG.001Home Care Client Collaborative Care ModelJun 12, 2022home-careclinical nursing
CLI.4110.PL.023.FORM.01Enteral Nutrition Standard OrdersJun 1, 2022across-care-areasclinical forms standard-order
CLI.6010.PL.015.FORM.01Medication Transportation FormJun 1, 2022pharmacyclinical forms
CLI.8011.PL.001.SD.07Infection Prevention and Control Hand Hygiene Poster Placement GuidelinesMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.FORM.014 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – CommunityMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.FORM.024 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – FacilityMay 5, 2022infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.017.SD.01.FClient Fact Sheet – Clostridioides Difficile – FrenchMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.017.SD.01Client Fact Sheet – Clostridioides difficileMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.SD.06General Hand Care Instructions Staff HandoutMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.SD.05Hand Hygiene Considerations in Facility DesignMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001Hand HygieneMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.SD.02SH SS Hand Hygiene How To Hand Rub and How to Hand Wash – Bilingual PostersMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.001.SD.08Visitors – Stop the Spread of Infections PosterMay 5, 2022infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.5910.SG.004.FORM.01Discharge Planning Checklist for Patients Receiving Palliative CareMay 3, 2022palliative-careclinical forms
CLI.5910.SG.004Discharge Planning for Palliative Care Patients from Hospital to CommunityMay 3, 2022palliative-careclinical
CLI.5413.SG.003.SD.01Back Up Plan Client InfoMay 3, 2022home-carecase-coordination clinical forms
CLI.5413.SG.003Back Up Plan for Service InterruptionMay 3, 2022home-carecase-coordination clinical
ORG.2010.SG.001.FORM.02Telehealth Client Survey SummaryApr 28, 2022telehealthforms organizational
ORG.2010.SG.001Telehealth Survey and SummaryApr 28, 2022telehealthorganizational
ORG.1511.PL.001Dress Code Attire and GroomingApr 26, 2022human-resourcesorganizational recruitment-and-retention
CLI.5415.PL.002Animals Pets in the Home and AreasMar 31, 2022home-careclinical
CLI.5411.PL.009.SD.01Client Home Care Standard Agreement Template ExampleMar 31, 2022home-careclinical service-delivery
CLI.5411.PL.009.FORM.03Client Home Care Standard Agreement TemplateMar 31, 2022home-careclinical forms service-delivery
CLI.5411.PL.009.FORM.01.FSuspension of Home Care Services Letter Template – FrenchMar 31, 2022home-careclinical forms service-delivery
CLI.5411.PL.009.FORM.01Suspension of Home Care Services Letter TemplateMar 31, 2022home-careclinical forms service-delivery
CLI.5411.PL.009.FORM.02.FWithdrawal of Home Care Services Letter Template – FrenchMar 31, 2022home-careclinical forms service-delivery
CLI.5411.PL.009.FORM.02Withdrawal of Home Care Services Letter TemplateMar 31, 2022home-careclinical forms service-delivery
CLI.5411.PL.009Interruption of Home Care ServicesMar 31, 2022home-careclinical service-delivery
ORG.1110.PL.003.SD.01When Media Calls Quick GuideMar 24, 2022communicationsorganizational
CLI.6410.PL.008Ear Cleaning EquipmentMar 22, 2022personal-care-homeclinical
CLI.6010.PL.009.SD.03Medication Reconciliation and Discharge Order Form BDM – ExampleMar 9, 2022pharmacyclinical
CLI.6010.PL.009.SD.02Medication Reconciliation Transfer Profile BDM Form – ExampleMar 9, 2022pharmacyclinical
CLI.6010.SG.009Vancomycin Monitoring in the Home Care Treatment ClinicMar 8, 2022pharmacyclinical
ORG.1411.PL.101.FORM.01Request to Access Personal Health InformationMar 3, 2022health-information-servicesforms organizational privacy-and-access
CLI.6410.PL.022.FORM.01Agreement to Share Personal Health Information in Personal Care Home – EnglishFeb 16, 2022personal-care-homeclinical forms
CLI.6410.PL.022.FORM.01.FAgreement to Share Personal Health Information in Personal Care Home – FrenchFeb 16, 2022personal-care-homeclinical forms
CLI.6410.PL.022Agreement to Share Personal Health Information in Personal Care HomeFeb 16, 2022personal-care-homeclinical
CLI.6410.PL.016.FORM.01.FPersonal Care Home Resident Agreement – FrenchFeb 4, 2022personal-care-homeclinical forms
CLI.6410.PL.016.FORM.01Personal Care Home Resident AgreementFeb 4, 2022personal-care-homeclinical forms
CLI.6410.PL.016Resident AgreementFeb 4, 2022personal-care-homeclinical
CLI.5415.PL.002.FORM.01.FHome Care Animals Pets Information Sheet – FrenchFeb 3, 2022home-careclinical forms
CLI.5415.PL.002.FORM.01Home Care Animals Pets Information SheetFeb 3, 2022home-careclinical forms
CLI.6310.PR.001.SD.01Choosing a Wheelchair for Use in a Personal Care HomeFeb 3, 2022rehabilitation-therapy-servicesclinical
CLI.6310.PR.001Wheelchair Acquisition Process in Personal Care HomesFeb 3, 2022rehabilitation-therapy-servicesclinical
ORG.1411.PL.101.FORM.06Request for Additional Infomation TemplateJan 28, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.07Notification of Abandoned Request TemplateJan 28, 2022health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.101.FORM.05Estimate of Fees for Access to Personal Health Information TemplateJan 28, 2022health-information-servicesforms organizational privacy-and-access
CLI.6310.SG.007.FORM.01Community Based Rehabilitation ReferralJan 28, 2022rehabilitation-therapy-servicesclinical forms
ORG.1411.PL.104Correction of Personal Health InformationJan 28, 2022health-information-servicesorganizational privacy-and-access
CLI.5411.PL.008.FORM.03Home Care Assigned Task Monitoring RecordJan 24, 2022home-careclinical forms service-delivery
CLI.5411.PL.008.FORM.01Home Care Assigned Task Training RequestJan 24, 2022home-careclinical forms service-delivery
CLI.5411.PL.008Home Care Assignment of Tasks to Home Care AttendantsJan 24, 2022home-careclinical service-delivery
CLI.5411.PL.008.FORM.02Home Care Attendant Ride Along ObservationJan 24, 2022home-careclinical forms service-delivery
CLI.5411.PL.008.SD.01Southern Health Sante Sud Assigned Task ListJan 24, 2022home-careclinical service-delivery
ORG.1410.PL.001.SD.03Client Chart Health Record Order Home Care Case CoordinatorJan 21, 2022health-information-serviceshealth-information organizational
CLI.6010.PL.023Cannabis for Medical PurposesJan 20, 2022pharmacyclinical
CLI.4110.PR.002.SD.01Post Immunization Anaphylaxis Management Kits List of ItemsJan 17, 2022across-care-areasclinical
CLI.4110.PL.022.FORM.02Ankle Brachial Pressure Index and Toe Brachial Pressure Index Client Appointment Instructions and InformationJan 4, 2022across-care-areasclinical forms
CLI.4110.PL.022.SD.01Ankle Brachial Pressure Index and Toe Brachial Pressure Index Education ModuleJan 4, 2022across-care-areasclinical
CLI.4110.PL.022.FORM.01Ankle Brachial Pressure Index and Toe Brachial Pressure Index RequestJan 4, 2022across-care-areasclinical forms
ORG.1411.PL.502Use and Disclosure of Personal Health InformationDec 20, 2021health-information-servicesorganizational privacy-and-access
CLI.4510.PL.011Chest Tubes and Chest Drainage SystemsNov 29, 2021across-hospital-unitsclinical
ORG.1312.FORM.002Miscellaneous InvoiceNov 23, 2021financeaccounts-receivable forms organizational
ORG.1411.PL.503.SD.03Video Surveillance NotificationNov 17, 2021health-information-servicesorganizational privacy-and-access
ORG.1411.PL.503.SD.01Respect Privacy Poster Long Term CareNov 17, 2021health-information-servicesorganizational privacy-and-access
ORG.1411.PL.503.SD.02Respect Privacy PosterNov 17, 2021health-information-servicesorganizational privacy-and-access
ORG.1411.PL.503Audio Video and Photographic Recording including SurveillanceNov 17, 2021health-information-servicesorganizational privacy-and-access
CLI.5910.PL.005.SD.001Anticipated Death at Home Information for Family Caregiver BilingualNov 8, 2021palliative-careclinical
CLI.5410.SG.003.FORM.01Application for Community Urgent StatusNov 8, 2021home-careaccess clinical forms
CLI.5410.SG.003.FORM.02Termination for Community Urgent StatusNov 8, 2021home-careaccess clinical forms
CLI.5910.PL.005.FORM.01Notification of Anticipated Death at HomeNov 2, 2021palliative-careclinical forms
CLI.5910.SG.005Palliative Care Telephone ConsultationNov 2, 2021palliative-careclinical
CLI.5410.SG.003Home Care Services Community UrgentNov 1, 2021home-careaccess clinical
CLI.5910.PL.005Anticipated Death at HomeOct 31, 2021palliative-careclinical
CLI.4110.PR.002Anaphylaxis Management Post Immunization in CommunityOct 28, 2021across-care-areasclinical
CLI.4110.PR.002.FORM.01Anaphylaxis Assessment Actions Record in CommunityOct 28, 2021across-care-areasclinical forms
CLI.4110.PR.002.SD.02Post Immunization Anaphylaxis Management Kit InsertOct 28, 2021across-care-areasclinical
CLI.8011.PL.008.SD.01Tuberculin Skin Test TST Referral GuidelineOct 27, 2021infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.FORM.001Tuberculin Skin Testing Fact SheetOct 27, 2021infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.008.FORM.05Occupational Safety and Health Employee TST Referral FormOct 27, 2021infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.6310.SG.002.FORM.01Rehab Services Outpatient ReferralOct 27, 2021rehabilitation-therapy-servicesclinical forms
ORG.1810.PL.008Audit Client ServiceOct 4, 2021quality-planning-and-performanceorganizational
ORG.1810.PL.008.FORM.01Regional Annual Audit Schedule TEMPLATEOct 4, 2021quality-planning-and-performanceforms organizational
ORG.1810.PL.008.SD.01Regional Audit GuideOct 4, 2021quality-planning-and-performanceorganizational
ORG.1810.PL.008.FORM.02Regional Audit Report TemplateOct 4, 2021quality-planning-and-performanceforms organizational
CLI.6010.PL.018Emergency Department Starter PacksSep 23, 2021pharmacyclinical
CLI.6010.PL.018.SD.01Starter Pack Dispensing ListSep 1, 2021pharmacyclinical forms
ORG.1411.PL.101.FORM.03Refusing a Request For AccessAug 27, 2021health-information-servicesforms organizational privacy-and-access
ORG.1910.PR.044Operation of Carpet ExtractorAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.046Cleaning of Floor PadsAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.053Cleaning Frequency Acute and Long Term BedsAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.058Cleaning Indoor Outdoor Visitation SheltersAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.055General Spill Biological Spill Clean UpAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.054General Waste ManagementAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.050Floor Burnishing Burnisher Floor Buffer Buffer Swing MachineAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.049Floor FinishingAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.047Floor Stripping with a Swing MachineAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.048Floor StrippingAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.056.FORM.01Mattress Inspection ReplacementAug 26, 2021support-servicesforms housekeeping organizational
ORG.1910.PR.056Mattress Inspection ReplacementAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.057Mattress RepairAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.043Operation of Auto ScrubberAug 26, 2021support-serviceshousekeeping organizational
Operation of Carpet ExtractorAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.045Operation of Rotary Swing Floor MachineAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.052Spray BuffingAug 26, 2021support-serviceshousekeeping organizational
ORG.1910.PR.058.SD.01Visitation Shelter Cleaning ChecklistAug 26, 2021support-servicesforms housekeeping organizational
ORG.1710.PL.001.FORM.01Purchase RequisitionAug 16, 2021logistics-and-supply-chain-managementforms organizational
CLI.5410.PL.006Home Care Smoking Vaping Cigarette Cigar and eCigarette in the HomeJul 30, 2021home-careaccess clinical forms
CLI.4110.PR.001.FORM.01Elsevier Clinical Skills Change RequestJul 7, 2021across-care-areasclinical forms
CLI.4110.PR.001Use of Elsevier Clinical SkillsJul 7, 2021across-care-areasclinical
CLI.5410.PL.005Policy Cannabis for Medical Purposes in the HomeJul 6, 2021home-careaccess clinical
ORG.1910.PR.018Cleaning Routine Occupied Client Resident RoomJun 18, 2021support-serviceshousekeeping organizational
ORG.1912.PL.005.FORM.01Annual Audit TrackingJun 15, 2021support-servicesfood-services forms organizational
ORG.1912.PL.005.FORM.14Regional Audit ReportJun 15, 2021support-servicesfood-services forms organizational
CLI.5110.SG.007Emergency Department Coordinated Care PlanJun 14, 2021critical-care-er-observation-scuclinical
CLI.5910.PL.010.FORM.01Palliative Care Social Work Referral FormJun 6, 2021palliative-careclinical forms
CLI.5910.PL.010Palliative Care Social Work ReferralJun 6, 2021palliative-careclinical
ORG.1912.PL.005.FORM.02Fridge Freezer Temperature RecordJun 1, 2021support-servicesfood-services forms organizational
CLI.4110.SG.011Silver Nitrate agNo3 Sticks for Wound Care GuidelineMay 31, 2021across-care-areasclinical
CLI.6010.SG.008.SD.02Finasteride Dissolve and Dose InstructionsMay 27, 2021pharmacyclinical forms
CLI.6010.SG.008.SD.03Cotrimoxazole Dissolve and Dose InstructionsMay 27, 2021pharmacyclinical
CLI.6410.SG.003Significant Weight Change Dietitian ReferralMay 20, 2021personal-care-homeclinical
CLI.8011.PR.001.SD.01Personal Protective Equipment PPE Donning and Doffing Observation GuideMay 3, 2021infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PR.001.FORM.01Personal Protective Equipment PPE Observation LogMay 3, 2021infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PR.001Personal Protective Equipment PPE Observer ProcedureMay 3, 2021infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6310.SG.003.SD.02Priority Rating Scale Adult AudiologyMay 3, 2021rehabilitation-therapy-servicesclinical
CLI.6010.SG.008.SD.01Dissolve and Dose Instructions TemplateMay 1, 2021pharmacyclinical forms
ORG.1513.PL.007.SD.01Workplace Safety and Health ProgramApr 27, 2021human-resourcesorganizational workplace-safety-and-health
ORG.1513.PL.007.SD.02Workplace Safety and Health Statement of CommitmentApr 27, 2021human-resourcesorganizational workplace-safety-and-health
ORG.1910.PR.036Cleaning of Drinking FountainsApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.035Cleaning of Hydrotherapy Jetted TubApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.037Cleaning of LCD Screens and BaseApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.042Clean Up and Disposal Clean Broken GlassApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.038Stripping Bed MakingApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.041Window Washing using a Gasoline Powered Pressure WasherApr 27, 2021support-serviceshousekeeping organizational
ORG.1910.PR.040Window Washing using an Electric Powered Pressure WasherApr 27, 2021support-serviceshousekeeping organizational
CLI.4510.PL.012.SD.01UK Vessel Health and Preservation 2020New overarching policy to provide formal direction on vascular access treatment therapies.Apr 21, 2021across-hospital-unitsclinical
CLI.6010.SG.007.SD.01Adult Treatment for Hypoglycemia Standard OrdersApr 14, 2021pharmacyclinical forms standard-order
CLI.6010.SG.007Emergency Management of Hypoglycemia Adult PediatricApr 14, 2021pharmacyclinical
CLI.6010.SG.001.FORM.01Vancomycin Prescriber Standard OrdersApr 14, 2021pharmacyclinical forms standard-order
CLI.6010.SG.007.SD.03Patient Handout Hypoglycemia Low Blood Sugar AdultApr 14, 2021pharmacyclinical
CLI.6010.SG.007.SD.02Pediatric Treatment for Hypoglycemia Standard OrdersApr 14, 2021pharmacyclinical forms
CLI.5110.SG.009Anaphylaxis Diagnosis and TreatmentApr 13, 2021critical-care-er-observation-scuclinical
ORG.1912.PL.008.FORM.01Meals On Wheels Dietary RequisitionMar 23, 2021support-servicesfood-services forms organizational
ORG.1912.PL.004Cleaning of EquipmentMar 8, 2021support-servicesfood-services organizational
ORG.1910.PR.028Cleaning of Chemo and DialysisMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.032Cleaning of Medical Device Reprocessing DepartmentMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.033Clean and Disinfecting of Public WashroomsMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.030Cleaning of All EntrancesMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.034Cleaning of UrinalsMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.029Cleaning of Waiting RoomsMar 3, 2021support-serviceshousekeeping organizational
ORG.1910.PR.031Cleaning Tubs ShowersMar 3, 2021support-serviceshousekeeping organizational
CLI.4110.SG.010Inpatient Rehabilitation Unit Criteria for AdmissionFeb 12, 2021across-care-areasclinical
CLI.4110.SG.010.FORM.01Regional Centre Inpatient Rehabilitation Unit ReferralFeb 12, 2021across-care-areasclinical forms
ORG.1210.PL.002Memorandum of Understanding for Emergency PreparednessFeb 1, 2021disaster-managementorganizational
ORG.1210.PL.002.FORM.01Memorandum of Understanding with Municipalities regarding Emergency PreparednessFeb 1, 2021disaster-managementforms organizational
ORG.1210.PL.002.FORM.01.FMemorandum of Understanding with Municipalities regarding Emergency Preparedness – FrenchFeb 1, 2021disaster-managementforms organizational
ORG. 1411.PL.006Preparing Fee Estimates under the Freedom of Information and Protection of Privacy Act FIPPAJan 29, 2021health-information-servicesorganizational privacy-and-access
CLI.6010.PL.024.SD.02Handling of Suspected Illicit Substance FAQsJan 28, 2021pharmacyclinical
CLI.5110.SG.009.SD.01Anaphylaxis AlgorithmJan 25, 2021critical-care-er-observation-scuclinical
CLI.5110.SG.009.FORM.02.FPatient Action Plan for Anaphylaxis FRENCHJan 25, 2021critical-care-er-observation-scuclinical forms
CLI.5110.SG.009.FORM.02Patient Action Plan for AnaphylaxisJan 25, 2021critical-care-er-observation-scuclinical forms
ORG.1910.PR.016Cleaning of Curtains BlindsJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.007Damp and Dry DustingJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.012VacuumingJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.013Wall WashingJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.011Wet Scrubbing Floors with a Swing Floor MachineJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.015Window Glass Door Washing InsideJan 22, 2021support-serviceshousekeeping organizational
ORG.1910.PR.014Window Glass Door Washing OutsideJan 22, 2021support-serviceshousekeeping organizational
ORG.1410.PL.402.SD.05Iron Mountain Permanent Withdrawal and DestructionJan 21, 2021health-information-serviceshealth-information organizational
ORG.1910.PR.022Cleaning of an Office Reception Area Meeting Rooms BoardroomsJan 18, 2021support-serviceshousekeeping organizational
ORG.1910.PR.023Cleaning of Laboratories XRayJan 18, 2021support-serviceshousekeeping organizational
ORG.1910.PR.025Cleaning ElevatorsJan 18, 2021support-serviceshousekeeping organizational
ORG.1910.PR.024Cleaning of StairwellsJan 18, 2021support-serviceshousekeeping organizational
ORG.1910.PR.027Cleaning of the MorgueJan 18, 2021support-serviceshousekeeping organizational
ORG.1410.PL.402Off Site Storage of RecordsJan 18, 2021health-information-serviceshealth-information organizational
ORG.1410.PL.402.SD.04Iron Mountain Searching in the Records CentreJan 18, 2021health-information-serviceshealth-information organizational
ORG.1410.PL.402.SD.01Iron Mountain Requesting ReportsJan 18, 2021health-information-serviceshealth-information organizational
ORG.1410.PL.402.FORM.01Iron Mountain Request to Add New DivisionJan 18, 2021health-information-servicesforms health-information organizational
ORG.1410.PL.402.FORM.02Iron Mountain Request to Add New DepartmentJan 18, 2021health-information-servicesforms health-information organizational
ORG.1410.PL.402.SD.03Iron Mountain Creating a Pickup OrderJan 18, 2021health-information-serviceshealth-information organizational
ORG.1410.PL.402.SD.02Iron Mountain Adding Boxes and FilesJan 18, 2021health-information-serviceshealth-information organizational
ORG.1410.PL.402.FORM.03Iron Mountain Access Form Request to Add or Delete UserJan 18, 2021health-information-servicesforms health-information organizational
Volunteer Induction WorksheetJan 15, 2021human-resourcesforms
CLI.6010.SG.001.FORM.02Vancomycin Pharmacist Standard OrdersJan 14, 2021pharmacyclinical forms
CLI.6310.SG.008Occupational Therapy Inpatient Referral PrioritizationNov 5, 2020rehabilitation-therapy-servicesclinical
CLI.6310.SG.009Physiotherapy Inpatient Referral PrioritizationNov 5, 2020rehabilitation-therapy-servicesclinical
ORG.1210.PL.001.FORM.02Employee Accessibility Plan for EmergenciesOct 29, 2020disaster-managementforms organizational
ORG.1910.PR.020Cleaning of an Occupied Isolation RoomOct 15, 2020support-serviceshousekeeping organizational
ORG.1910.PR.021Cleaning of a Discharged Client Resident Isolation RoomOct 15, 2020support-serviceshousekeeping organizational
ORG.1910.PR.019Cleaning of a Routine Discharged Client Resident RoomOct 15, 2020support-serviceshousekeeping organizational
ORG.1910.PR.017Project Cleaning RoomsOct 15, 2020support-serviceshousekeeping organizational
CLI.4110.PL.018.FORM.01Oral Health Assessment and Care Plan GuideOct 8, 2020across-care-areasclinical forms
CLI.8011.PL.013Pneumococcal Vaccine Administration to Residents in Personal Care HomesOct 5, 2020infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.4110.PL.017.FORM.04Post Exposure to Blood and Body Fluids Instruction Record BilingualSep 30, 2020across-care-areasclinical forms
CLI.4110.PL.017Post Exposure Prophylaxis for Human Immunodeficiency Virus HIV Hepatitis B Virus HBV or Hepatitis C Virus HCVSep 30, 2020across-care-areasclinical
CLI.4110.PL.017.FORM.09Post Exposure to Blood and Body Fluids ReferralsSep 30, 2020across-care-areasclinical forms
CLI.4110.PL.017.FORM.01Post Exposure to Blood and Body Fluids Risk Assessment and ManagementSep 30, 2020across-care-areasclinical forms
ORG.1110.PL.010.FORM.01Public Website Events Calendar SubmissionSep 10, 2020communicationsforms organizational
ORG.1710.PL.001.FORM.02Product Vendor ComplaintSep 8, 2020logistics-and-supply-chain-managementforms organizational
ORG.1411.SG.001Emailing Confidential InformationSep 4, 2020health-information-servicesorganizational privacy-and-access
ORG.1411.SG.001.SD.01Email Acknowledgment and AgreementSep 4, 2020health-information-servicesorganizational privacy-and-access
CLI.8011.SG.005Portable Fan Usage in Healthcare FacilitiesJul 23, 2020infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.4510.PL.010.FORM.02Review of Contraband ItemsJun 29, 2020across-hospital-unitsclinical forms
CLI.4510.PL.010Suicide Prevention Acute CareJun 29, 2020across-hospital-unitsclinical
CLI.4510.PL.010.FORM.03Suicide Prevention Chart AuditJun 29, 2020across-hospital-unitsclinical forms
CLI.4510.PL.010.SD.01Suicide Prevention Sample Interview QuestionsJun 29, 2020across-hospital-unitsclinical
CLI.4510.PL.010.FORM.01Suicide Screening Risk Assessment and Care PlanningJun 29, 2020across-hospital-unitsclinical forms
CLI.5110.PL.008.SD.01Law Enforcement Peace Officer Involvement during MH Patient Transport AlgorithmJun 29, 2020critical-care-er-observation-scuclinical
CLI.5110.PL.008.FORM.01Level of Supervision Mental HealthJun 29, 2020critical-care-er-observation-scuclinical forms
CLI.5110.PL.008Transfer of Custody of an Involuntary Patient under the Mental Health ActJun 29, 2020critical-care-er-observation-scuclinical
Midwifery Billing FormJun 1, 2020finance primary-health-careforms
CLI.8011.PL.014Bed Bug Management in Acute Care and Personal Care HomeMay 19, 2020infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
ORG.1111.PL.001.SD.02Regional Health Authorities Act BilingualApr 24, 2020french-language-servicesorganizational
CLI.6210.PL.001.SD.03.FContraceptive Health Services Letter – FrenchApr 8, 2020public-health-healthy-livingclinical forms
CLI.6210.PL.001.SD.03Contraceptive Health Services LetterApr 8, 2020public-health-healthy-livingclinical forms
CLI.6210.PL.001.FORM.01.FReproductive Health History – FrenchApr 8, 2020public-health-healthy-livingclinical forms
CLI.6210.PL.001.FORM.01Reproductive Health HistoryApr 8, 2020public-health-healthy-livingclinical forms
CLI.6210.PL.001.FORM.02Reproductive Health RecordApr 8, 2020public-health-healthy-livingclinical forms
ORG.1110.PL.004.SD.01Photo Video Audio General PosterApr 7, 2020communicationsorganizational
CLI.6410.PL.003Information Transfer at Care Transition Personal Care HomeMar 24, 2020personal-care-homeclinical
CLI.4110.PL.010Information Transfer at Care TransitionMar 20, 2020across-care-areasclinical
CLI.4110.PL.020.FORM.01Public Guardian and Trustee of Manitoba Client Transfer NoticeMar 20, 2020across-care-areasclinical forms
CLI.4110.PL.019Power Mobility DeviceMar 6, 2020across-care-areasclinical
CLI.4110.PL.019.FORM.01Power Mobility Device User Judgment GuidelineMar 6, 2020across-care-areasclinical forms
CLI.4110.PL.019.SD.02Process Map Power Mobility Device Assessment New UserMar 6, 2020across-care-areasclinical
CLI.4110.PL.019.SD.01Process Map Power Mobility Device Assessment Existing UserMar 6, 2020across-care-areasclinical
CLI.4110.PL.019.SD.03Power Mobility Device Frequently Asked Questions for NursingMar 6, 2020across-care-areasclinical
CLI.4110.PL.019.FORM.02Power Mobility Device Safety and Care Information SheetMar 6, 2020across-care-areasclinical forms
CLI.4110.PL.019.FORM.O3Power MobilityDevice User Agreement FormMar 6, 2020across-care-areasclinical forms
ORG.1310.PL.004ParkingMar 6, 2020financeorganizational
ORG.1510.PL.004.FORM.01Regional Orientation Registration FormFeb 7, 2020human-resourcesforms organizational
ORG.1411.PL.505.FORM.01Disclosure of Personal Health Information to Police Without Consent FormFeb 4, 2020health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.505Disclosure of Personal Health Information to PoliceFeb 4, 2020health-information-servicesorganizational privacy-and-access
ORG.1910.PR.003Appearance Standards Client Resident RoomsJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.004Appearance Standards WashroomsJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.005Cleaning Appearance Standards General Room AreaJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.008Dry Mopping FloorsJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.006Preparation of a Housekeeping CartJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.010Wet Mopping Floors Microfiber Mopping SystemJan 29, 2020support-serviceshousekeeping organizational
ORG.1910.PR.009Wet Mopping Floors Yacht Style MopJan 29, 2020support-serviceshousekeeping organizational
ORG.1314.FORM.002Payroll Discrepancy FormJan 27, 2020finance human-resourcesforms
ORG.1010.SG.003Postponement of Education SessionsJan 13, 2020administrationorganizational
CLI.8011.PL.015Reporting of Infectious Diseases and Conditions by HCPs in AC and PCHJan 7, 2020infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.SG.001.SD.02Urine Trouble BilingualDec 17, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.4110.PL.006Medical Assistance In Dying MAIDDec 10, 2019across-care-areasclinical
CLI.4110.PL.006.FMedical-Assistance-in-Dying (MAID) – FrenchDec 10, 2019across-care-areasclinical
ORG.1911.PR.030Cleaning DryersDec 2, 2019support-serviceslaundry organizational
ORG.1911.PR.027Cleaning Equipment Areas Clean Soiled Areas Laundry DepartmentDec 2, 2019support-serviceslaundry organizational
ORG.1911.PR.029Cleaning Weigh Scale Floor ModelDec 2, 2019support-serviceslaundry organizational
ORG.1911.PR.028Cleaning Weigh Scale Poly Basket ModelDec 2, 2019support-serviceslaundry organizational
CLI.5810.PL.010AmnioinfusionNov 14, 2019obstetricsclinical
CLI.5810.PL.008.SD.01Newborn Pulse Oximetry Flow ChartNov 14, 2019obstetricsclinical
CLI.5810.PL.008Newborn Pulse Oximetry Monitoring Upon DischargeNov 14, 2019obstetricsclinical
CLI.5810.PL.009Pain Management in LabourNov 14, 2019obstetricsclinical
CLI.6210.SG.010.SD.02Pregnancy Resources – BilingualOct 31, 2019public-health-healthy-livingclinical
CLI.6110.PL.002Falls Prevention Primary Health Care PHCOct 30, 2019primary-health-careclinical
CLI.6110.PL.002.FORM.01.FFall Prevention Environmental Audit PHC FrenchOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.01Fall Prevention Environmental Audit PHCOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.03.FPrimary Health Care Client Falls Risk Screening Tool FrenchOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.03Primary Health Care Client Falls Risk Screening ToolOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.02Staying on your Feet ChecklistOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.02.FStaying on your Feet Checlist FrenchOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.04.FYour Fall Risk Factors Form FrenchOct 30, 2019primary-health-careclinical forms
CLI.6110.PL.002.FORM.04Your Fall Risk Factors FormOct 30, 2019primary-health-careclinical forms
CLI.6410.PL.017.FORM.01Personal Care Home Acceptance LetterOct 29, 2019personal-care-homeclinical forms
ORG.1411.PL.502.FORM.03Record of Access Disclosure Release of Personal Health InformationOct 29, 2019health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.502.FORM.02.FConsent to Use Personal Health Information Form – FrenchOct 29, 2019health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.502.FORM.02Consent to Use Personal Health Information FormOct 29, 2019health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.502.FORM.01.FConsent to Disclose Personal Health Information Form – FrenchOct 29, 2019health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.502.FORM.01Consent to Disclose Personal Health InformationOct 29, 2019health-information-servicesforms organizational privacy-and-access
ORG.1311.PR.001.FORM.01Accounts Payable Batch HeaderOct 29, 2019financeaccounts-payable forms organizational
ORG.1311.PR.001.FORM.02Accounts Payable Batch LogOct 29, 2019financeaccounts-payable forms organizational
ORG.1311.PR.001.FORM.03Accounts Payable Coding StampOct 29, 2019financeaccounts-payable forms organizational
CLI.4110.SG.008Nurse Practitioner Regional Practice GuidelineOct 28, 2019across-care-areasclinical
ORG.1311.PR.001Accounts Payable ProcessesOct 22, 2019financeaccounts-payable organizational
CLI.5810.PL.002.FORM.02Labour PartographOct 10, 2019obstetricsclinical forms
CLI.4110.PL.017.FORM.03Post Exposure to Blood and Body Fluids Laboratory Testing of SourceSep 30, 2019across-care-areasclinical forms
Breastfeeding Welcome Here OrderSep 30, 2019public-health-healthy-livingforms
CLI.5411.SG.007.SD.01Home Care Client Information Sheet SuppliesSep 29, 2019home-careclinical forms service-delivery
CLI.5910.PL.009Thoracentesis Catheter Intermittent Drainage of Pleural Fluid and Care of Long TermSep 27, 2019palliative-careclinical
ORG.1510.PL.004Regional Orientation ProgramSep 27, 2019human-resourcesorganizational
CLI.5810.FORM.048Standard Orders Hypertensive Disorders of Pregnancy finalSep 24, 2019obstetricsclinical forms standard-order
ORG.1510.PL.005.SD.01Respectful Workplace Procedures ManualSep 21, 2019human-resourcesorganizational
CPCP Consult RequestSep 20, 2019palliative-careforms
CLI.6010.PR.001Operating Room Management of Narcotic Controlled MedicationsSep 18, 2019pharmacyclinical
CLI.6010.PR.001.FORM.01OR Anesthetist DCMRSep 18, 2019pharmacyclinical forms
CLI.6010.PR.001.FORM.02OR Nursing DCMRSep 18, 2019pharmacyclinical forms
CLI.6110.FORM.001Regional Chronic Disease Education Team and Community Dietitian Referral FormSep 17, 2019primary-health-careclinical forms
CLI.6110.FORM.002Regional Chronic Disease Education Team and Community Dietitian Self Referral FormSep 17, 2019primary-health-careclinical forms
CLI.6010.PL.015.SD.01MAR Example Acute Patch Application and RemovalSep 17, 2019pharmacyclinical
CLI.4110.PL.018.SD.01Oral Hygiene Levels of Care ProceduresSep 16, 2019across-care-areasclinical
CLI.4110.PL.018Oral HygieneSep 16, 2019across-care-areasclinical
CLI.8011.SG.001Standard Guideline Diagnosis and Management of Urinary Tract Infections in Long Term CareSep 9, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.SG.001.SD.01Urinary Tract Infection – Clinical Care MapSep 9, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6210.SG.009.SD.01How to Keep Your Breast Pump CleanSep 9, 2019public-health-healthy-livingclinical
ORG.1511.PL.008.FORM.01Return of Service Agreement For Existing EmployeesSep 5, 2019human-resourcesforms organizational recruitment-and-retention
ORG.1911.PR.011Cleaning of Linen Clothing Delivery CartsSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.013Laundry Chemical Treatment ProcedureSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.016Person in ChargeSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.017Pick Up and Transportation of Laundry Linen Using a VanSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.024Pick Up and Transportation of Soiled Laundry with Possible Lice Bed Bug InfestationSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.012Laundry Equipment Identification ListSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.010Linen QuotasSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.014Loading Clean Linen Clothing CartsSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.015Lost and FoundSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.018Separation of Clean and Soiled Equipment Laundry AreasSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.019Sorting Soiled LaundrySep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.025Stained Linen Clothing Treatment and RewashSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.021Storage of Soiled Laundry in the Laundry DepartmentSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.020Storage of Soiled Laundry on Client Service AreasSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.023Transporting Laundry and Linen with a Lift VehicleSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.022Transporting Laundry In HouseSep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.026Weighing Soiled LaundrySep 3, 2019support-serviceslaundry organizational
ORG.1911.PR.012.FORM.01Laundry Equipment Identification ListSep 1, 2019support-servicesforms laundry organizational
CLI.6210.SG.004.SD.01Community Breastfeeding Resources ListAug 28, 2019public-health-healthy-livingclinical
CLI.6210.SG.004.SD.05Thrush Client Teaching HandoutAug 28, 2019public-health-healthy-livingclient-teaching-handouts clinical
CLI.6410.PL.014.FORM.02Fall Prevention and Management in PCH Falls Prevention Intervention ChecklistAug 23, 2019personal-care-homeclinical forms
CLI.4110.PL.017.SD.04Antiretroviral Medications Side EffectsAug 23, 2019across-care-areasclinical
CLI.4110.PL.017.SD.02.FManitoba Health What You Should Know – FrenchAug 23, 2019across-care-areasclinical
CLI.4110.PL.017.SD.02Manitoba Health What You Should KnowAug 23, 2019across-care-areasclinical
CLI.4110.PL.017.SD.03.FMedications to Reduce the Risk of HIV Infection – FrenchAug 23, 2019across-care-areasclinical
CLI.4110.PL.017.SD.03Medications to Reduce the Risk of HIV InfectionAug 23, 2019across-care-areasclinical
CLI.4110.PL.011.FORM.01Monthly Mobility Equipment Inspection ChecklistAug 23, 2019across-care-areasclinical forms
CLI.4110.PL.017.SD.01Post Exposure to Blood and Body Fluids AlgorithmAug 23, 2019across-care-areasclinical
CLI.6210.SG.010.SD.01Manitoba Public Health Nurse Prenatal ReferralAug 20, 2019public-health-healthy-livingclinical forms
CLI.5810.PL.007Hepatitis B prophylaxis in Newborns PolicyAug 12, 2019obstetricsclinical
CLI.5415.PL.001.FORM.01SBAR Clinical Home CareJun 26, 2019home-carecase-coordination clinical forms
CLI.4110.PL.017.FORM.02Post Exposure to Blood and Body Fluids Source Consent BilingualJun 16, 2019across-care-areasclinical forms
CLI.4110.PL.017.FORM.08Outpatient prescription HIV PEP PediatricJun 14, 2019across-care-areasclinical forms
CLI.4110.PL.017.FORM.05Post Exposure Prophylaxis to Blood and Body Fluids Standard Orders AdultJun 14, 2019across-care-areasclinical forms
CLI.4110.PL.017.FORM.06Post Exposure Prophylaxis to Blood and Body Fluids Standard Orders PediatricJun 14, 2019across-care-areasclinical forms
CLI.8011.PL.017.FORM.07Outpatient Prescription HIV PEP AdultJun 14, 2019across-care-areasclinical forms
ORG.1313.PL.001.FORM.02Equipment Needs ListingJun 10, 2019financecapital forms
ORG.1313.PL.001Equipment AuthorizationJun 10, 2019financecapital organizational
ORG.1311.FORM.002Direct Deposit Form EmployeeJun 6, 2019financeaccounts-payable forms organizational
ORG.1311.FORM.003Direct Deposit Form VendorJun 6, 2019financeaccounts-payable forms organizational
CLI.4110.PL.016.SD.01Personal Health Information Disclosure Due to Risk of Serious Harm AlgorithmJun 4, 2019across-care-areasclinical
CLI.4110.PL.016Personal Health Information Disclosure Due to Risk of Serious HarmJun 4, 2019across-care-areasclinical
CLI.5411.SG.002.SD.01Home Care Client Information Sheet Mobility Exercise Transfer PositioningMay 23, 2019home-careclinical service-delivery
CLI.5510.PL.002.FORM.01Transportation Inventory ListMay 8, 2019medical-device-reprocessingclinical forms
ORG.1913.PL.001Preventative Maintenance on EquipmentMay 3, 2019support-servicesorganizational physical-plant
CLI.6210.SG.007Tuberculosis Public Health Management of Contacts GuidelineMay 1, 2019public-health-healthy-livingclinical
CLI.6110.PL.003.FORM.01Client Experience Survey FormMay 1, 2019primary-health-careclinical forms
CLI.6110.PL.003.FORM.01.FClient Experience Survey Form FrenchMay 1, 2019primary-health-careclinical forms
CLI.6110.PL.003Client Experience SurveyMay 1, 2019primary-health-careclinical
ORG.1513.PL.006.FORM.01Person of Interest Safety Plan and Safe Workplace Notification GuideApr 25, 2019human-resourcesforms organizational workplace-safety-and-health
ORG.1513.SG.002Person of Interest Standard GuidelineApr 25, 2019human-resourcesorganizational workplace-safety-and-health
CLI.6410.PL.021.FORM.03Geriatric Depression Scale GDS Short FormApr 17, 2019personal-care-homeclinical forms
CLI.6410.PL.021.SD.01Regional PCH Suicide Risk Assessment Resource GuideApr 17, 2019personal-care-homeclinical
CLI.6410.PL.021.FORM.02Risk Assessment for Suicide Tool RASTApr 17, 2019personal-care-homeclinical forms
CLI.6410.PL.021.FORM.04SIG E CAPS Screening for DepressionApr 17, 2019personal-care-homeclinical forms
CLI.6410.PL.021.FORM.01Suicide Risk Screening ToolApr 17, 2019personal-care-homeclinical forms
ORG.1610.PL.003Allocation of Information Communication Technology DevicesApr 15, 2019information-and-communication-technologyorganizational
ORG.1610.PL.002Appropriate Use of Information and Communication TechnologyApr 15, 2019information-and-communication-technologyorganizational
ORG.1610.PL.001Information and Communication Technology SecurityApr 15, 2019information-and-communication-technologyorganizational
ORG.1610.PL.004Remote Access to Corporate NetworkApr 15, 2019information-and-communication-technologyorganizational
ORG.1511.SG.001Student Incentive Grant and LPN to BN Education Bursary for Existing EmployeesApr 12, 2019human-resourcesorganizational recruitment-and-retention
ORG.1511.SG.001.FORM.01Student Incentive Grant ApplicationApr 12, 2019human-resourcesforms organizational recruitment-and-retention
ORG.1511.SG.001.FORM.02Student Incentive Grant Practical Nursing ApplicationApr 12, 2019human-resourcesforms organizational recruitment-and-retention
ORG.1511.SG.001.FORM.03LPN to BN Education Bursary ApplicationApr 12, 2019human-resourcesforms organizational recruitment-and-retention
CLI.6010.PL.023.SD.01Algorithm For Continued Use of Medical CannabisApr 2, 2019pharmacyclinical
CLI.6010.PL.023.SD.02Algorithm for Medical Cannabis New Starts and Authorization RenewalsApr 2, 2019pharmacyclinical
CLI.6010.PL.023.SD.03Cannabis Equivalency Chart and Active Ingredient ConcentrationApr 2, 2019pharmacyclinical
CLI.6010.PL.023.FORM.01, CLI.6010.PL.023.FORM.01.FCannabis for Medical Purposes Agreement for Use and Release of Responsibility – BilingualApr 2, 2019pharmacyclinical forms
CLI.6010.PL.023.SD.04Cannabis Product MonographApr 2, 2019pharmacyclinical
CLI.6010.PL.023.SD.05Consumer Information Cannabis – BilingualApr 2, 2019pharmacyclinical
CLI.6010.PL.024Handling of Suspected Illicit SubstanceMar 28, 2019pharmacyclinical
CLI.6010.PL.024.SD.01Suspected Illicit Substance AlgorithmMar 28, 2019pharmacyclinical
CLI.6010.PL.024.FORM.01Suspected Illicit Substance TransferMar 28, 2019pharmacyclinical forms
CLI.6010.PL.002.SD.01Look alike Sound alike Names with TALLman LetteringMar 28, 2019pharmacyclinical
CLI.6010.PL.002Look alike Sound alikeMar 28, 2019pharmacyclinical
ORG.1511.PL.008.FORM.02Interest Free Loan Promissory NoteMar 22, 2019human-resourcesforms organizational recruitment-and-retention
ORG.1511.PL.008Professional Development Training Education AssistanceMar 22, 2019human-resourcesorganizational recruitment-and-retention
CLI.6310.FORM.003Rehab Services Integrated Progress NoteMar 22, 2019rehabilitation-therapy-servicesclinical forms
CLI.5411.SG.002Home Care Services Mobility Exercise and Transfer PositioningMar 15, 2019home-careclinical service-delivery
CLI.5411.SG.001.SD.02Home Care Client Information Sheet Household Maintenance and LaundryMar 15, 2019home-careclinical service-delivery
CLI.5411.SG.008.SD.01Home Care Client Information Sheet Meal PreparationMar 15, 2019home-careclinical forms service-delivery
CLI.5411.SG.006.SD.01Home Care Client Information Sheet EquipmentMar 15, 2019home-careclinical forms service-delivery
CLI.5411.SG.009.SD.02Home Care Client Information Sheet Personal Care and HygieneMar 15, 2019home-careclinical forms service-delivery
CLI.5411.PL.007.SD.01.FHome Care Information Pamphlet – FrenchMar 15, 2019home-careclinical service-delivery
CLI.5411.PL.007Home Care ServiceMar 15, 2019home-careclinical service-delivery
CLI.6010.PL.006.SD.01IV to PO Step Down Criteria and ChartMar 13, 2019pharmacyclinical
CLI.6010.PL.004.SD.01Adult ORAL and PARENTERAL Antibiotics Renal Dosing Chart 1Mar 13, 2019pharmacyclinical
CLI.6010.SG.001Adult Vancomycin Monitoring and DosingMar 13, 2019pharmacyclinical
CLI.6010.PL.006Antimicrobial Intravenous to Oral Therapeutic ConversionMar 13, 2019pharmacyclinical
CLI.6210.SG.006Tuberculosis Public Health Management of DOT or DOPT GuidelineMar 1, 2019public-health-healthy-livingclinical
CLI.6210.SG.007.FORM.01Tuberculosis Contact AssessmentMar 1, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.007.FORM.03Tuberculosis Contact Screening Parameters ToolMar 1, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.006.FORM.02Tuberculosis Medication Side Effect Check ListMar 1, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.006.FORM.01Procedures for Tuberculosis DOT or DOPTMar 1, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.006.FORM.03Checklist for Tuberculosis DOT DOPT Education SessionMar 1, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.007.FORM.02Tuberculosis Summary of ContactsMar 1, 2019public-health-healthy-livingclinical forms
ORG.1511.PL.007Professional CredentialingFeb 26, 2019human-resourcesorganizational recruitment-and-retention
ORG.1110.FORM.001Client Teaching Handout TemplateFeb 24, 2019communicationsforms organizational
CLI.5910.SG.001.FORM.02Edmonton Symptom Assessment System Revised GraphFeb 8, 2019palliative-careclinical forms
CLI.6710.PL.002.SD.01Adult Day Program Procedures ManualFeb 6, 2019seniors-services-communityclinical
CLI.6710.PL.002Adult Day Program Procedures ManualFeb 6, 2019seniors-services-communityclinical
ORG.1411.PL.411.FORM.01The Protecting Children Information Sharing Act Information RequestFeb 5, 2019health-information-servicesforms organizational privacy-and-access
ORG.1411.PL.411.SD.01The Protecting Children Information Sharing Act Decision Making ToolFeb 5, 2019health-information-servicesorganizational privacy-and-access
ORG.1411.PL.411.SD.02Question and Answer Guide for The Protection of Children Information Sharing ActFeb 5, 2019health-information-servicesorganizational privacy-and-access
ORG.1411.PL.411Information and Sharing under The Protecting Children Information Sharing Act PCISAFeb 5, 2019health-information-servicesorganizational privacy-and-access
CLI.8011.PL.010.SD.03Infection Control Construction Barrier Sign EnglishFeb 4, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.SD.03.FInfection Control Construction Barrier Sign FrenchFeb 4, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.FORM.03Infection Control Post Construction ChecklistFeb 4, 2019infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.SD.02Infection Control Preventive Measures PlanFeb 4, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.FORM.01Infection Control Risk Assessment ICRA for Health Care FacilityFeb 4, 2019infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.FORM.02Infection Control Site Monitoring ToolFeb 4, 2019infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010Infection Prevention During Construction Renovation and MaintenanceFeb 4, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.FORM.04Construction Air Handling Inspection SheetFeb 4, 2019infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.FORM.05Pressure Differential Daily ChecklistFeb 4, 2019infection-prevention-and-controlclinical forms infection-prevention-and-control-policies-and-guidelines
CLI.8011.PL.010.SD.01Preventive Measures Quick Reference ListFeb 4, 2019infection-prevention-and-controlclinical infection-prevention-and-control-policies-and-guidelines
CLI.6210.PR.002Violence Prevention Program in Public Health Healthy Living Office SettingFeb 1, 2019public-health-healthy-livingclinical
CLI.6210.PR.003Violence Prevention Program Provision of Care in the Home Public Health Healthy LivingFeb 1, 2019public-health-healthy-livingclinical
ORG.1710.PL.010Regional Fleet Safety and Regulatory Requirements ManagementJan 28, 2019logistics-and-supply-chain-managementorganizational
ORG.1710.PL.010.FORM.05Vehicle Maintenance FormJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.SD.01Vehicle Pre Trip Inspection CriteriaJan 28, 2019logistics-and-supply-chain-managementorganizational
ORG.1710.PL.010.FORM.08Vehicle Recall FormJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL010.FORM.03Driver Fitness DeterminationJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.FORM.01Driver Safety Data WorksheetJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.FORM.07Event ReportJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.FORM.02Event Reporting and TrackingJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.FORM.09Fleet Vehicle Usage ReportJan 28, 2019logistics-and-supply-chain-managementforms organizational
ORG.1710.PL.010.FORM.06Pre Trip InspectionJan 28, 2019logistics-and-supply-chain-managementforms organizational
CLI.4510.PL.007Observation Services DesignationJan 25, 2019across-hospital-unitsclinical
CLI.6010.PL.021.SD.01Cytotoxic and Non Cytotoxic Hazardous Medication ListJan 24, 2019pharmacyclinical
CLI.6010.PL.021.SD.03Cytotoxic Spill Management AlgorithmJan 24, 2019pharmacyclinical
CLI.6010.PL.009.FORM.02Discharge Medication PlanJan 24, 2019pharmacyclinical forms
CLI.6010.PL.011.SD.01Do Not Use Dangerous Abbreviations Symbols Dose DesignationsJan 24, 2019pharmacyclinical
CLI.6010.PL.021Safe Handling of Hazardous Medications Cytotoxic and Non CytotoxicJan 24, 2019pharmacyclinical
CLI.6010.PL.021.SD.02Safe Handling of Hazardous Medications ChartJan 24, 2019pharmacyclinical
CLI.6010.PL.009.FORM.03Transfer Reconciliation and OrderJan 24, 2019pharmacyclinical forms
CLI.6010.PL.022.FORM.01Patient Resident Leave of Absence Medication RequestJan 24, 2019pharmacyclinical forms
CLI.6010.PL.022PatientResident Leave of Absence MedicationsJan 24, 2019pharmacyclinical
CLI.5810.PL.006Twin DeliveryJan 22, 2019obstetricsclinical
CLI.6210.SG.009Breast Pump Loaning GuidelineJan 21, 2019public-health-healthy-livingclinical
CLI.6210.SG.009.FORM.01.FBreast Pump Loaner Agreement – FrenchJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.009.FORM.01Breast Pump Loaner AgreementJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.009.FORM.02Breast Pump Loaner Tracking FormJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.008.FORM.02Manitoba Health Vaccine and Biologics OrderJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.008.FORM.06Rabies Post Exposure Protocol Client Did Not Show Letter – BilingualJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.008.FORM.05Rabies Unable to Contact Animal Owner Letter – BilingualJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.008.FORM.04Rabies Unable to Contact Exposed Letter – BilingualJan 21, 2019public-health-healthy-livingclinical forms
CLI.6210.SG.008.FORM.01Report of Suspected Rabies ExposureJan 21, 2019public-health-healthy-livingclinical forms
ORG.1511.PL.003Exit InterviewJan 15, 2019human-resourcesorganizational recruitment-and-retention
CLI.6410.PL.020Acceptance or Refusal of a Personal Care Home BedJan 11, 2019personal-care-homeclinical
CLI.6410.PL.019Transfer and Out of Region Personal Care Homes RequestsJan 11, 2019personal-care-homeclinical
CLI.6410.PL.017Personal Care Home Waitlist ManagementDec 5, 2018personal-care-homeclinical
CLI.6611.PL.002.FORM.02Surgical Safety Checklist Observational Audit and AnalysisDec 5, 2018perioperativeclinical forms surgical-unit-same-day-surgery
CLI.6611.PL.002.FORM.01Surgical Safety ChecklistDec 5, 2018perioperativeclinical forms surgical-unit-same-day-surgery
CLI.4110.PL.011.SD.01Pre-use Mobility Equipment InspectionDec 1, 2018across-care-areasclinical
ORG.1313.PL.001.SD.02Basic Contingent Capital Equipment Request and Authorization ProcessNov 30, 2018financecapital organizational
ORG.1313.PL.001.SD.01Basic Planned Capital Equipment Request and Authorization ProcessNov 30, 2018financecapital organizational
ORG.1313.PL.001.SD.03Donated Capital Equipments Request and Authorization ProcessNov 30, 2018financecapital organizational
CLI.6410.PL.018Veterans Beds in Personal Care HomesNov 28, 2018personal-care-homeclinical
ORG.1411.PL.201.SD.01PHIA Self Learning Package GeneralNov 8, 2018health-information-servicesorganizational privacy-and-access
ORG.1410.PL.550.SD.01Data Report Naming ConventionNov 5, 2018health-information-serviceshealth-information organizational
ORG.1111.PL.002FLS Communication in Official LanguagesNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.003FLS Designation of Bilingual Sites and PositionsNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.001FLS General PolicyNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.004FLS TranslationNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.001.SD.01Government of Manitoba French Language Services Policy BilingualNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.002.FSLF Communications dans les langues officiellesNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.003.FSLF Designation des etablissements et des postes bilinguesNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.001.FSLF Politique généraleNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.004.FSLF TraductionNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.001.SD.03Concentration of Francophone population in Southern Health Santé Sud Census 2016Nov 1, 2018french-language-servicesorganizational
ORG.1111.PL.001.SD.04Development Approval Process FLS Plans BilingualNov 1, 2018french-language-servicesorganizational
ORG.1111.PL.002.SD.01FLS Greeting ToolNov 1, 2018french-language-servicesorganizational
ORG.1410.PL.550Health Information Data Request ProcessOct 29, 2018health-information-serviceshealth-information organizational
ORG.1410.PL.550.FORM.01Health Information Data Request FormOct 29, 2018health-information-servicesforms health-information organizational
CLI.4110.PL.011Mobility Equipment InspectionsOct 17, 2018across-care-areasclinical
CLI.5411.SG.001.SD.01Case Coordinator Considerations Household Maintenance and LaundrySep 29, 2018home-careclinical service-delivery
CLI.5411.SG.005.SD.02Case Coordinator Service Considerations EliminationSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.001Home Care Services Household Maintenance and LaundrySep 29, 2018home-careclinical service-delivery
CLI.5411.SG.009Home Care Services Personal Care and HygieneSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.007Home Care Services SuppliesSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.005.SD.01Home Care Client Information Sheet EliminationSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.006Home Care Service EquipmentSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.005Home Care Services EliminationSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.006.SD.02Responsibility For Payment for Equipment and SuppliesSep 29, 2018home-careclinical service-delivery
CLI.5411.SG.009.SD.01Case Coordination Service Considerations Personal CareSep 28, 2018home-careclinical service-delivery
ORG.1511.PL.006.FORM.01Take Our Kids To Work Agreement and UndertakingSep 28, 2018human-resourcesforms organizational recruitment-and-retention
ORG.1511.PL.006Take Our Kids To WorkSep 28, 2018human-resourcesorganizational recruitment-and-retention
ORG.1511.PL.005Job ShadowingSep 28, 2018human-resourcesorganizational recruitment-and-retention
ORG.1511.PL.005.FORM.01Personal Health Information Act Information and Agreement for Persons Job ShadowingSep 28, 2018human-resourcesforms organizational recruitment-and-retention
CLI.5411.SG.010.SD.01Case Coordinator Considerations Oral Feeding without Swallowing DisorderSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.003.SD.01Case Coordinator Service Consideration for Respite Care in the HomeSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.008Home Care Services Meal PreparationSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.004Home Care Services Off Site ServiceSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.003Home Care Services Respite Care In the HomeSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.008.SD.02Home Care Case Coordinator Service Considerations Meal PreparationSep 28, 2018home-careclinical service-delivery
CLI.5411.PL.007.SD.01Home Care Information BookletSep 28, 2018home-careclinical service-delivery
CLI.5411.SG.010Oral Feeding without Swallowing DisorderSep 28, 2018home-careclinical service-delivery
ORG.1010.PL.001.FORM.03Suspension of Services Internal MemoSep 12, 2018administrationforms organizational
CLI.5110.PR.012.FORM.02Discharge Instructions Record Emergency Department Chart AuditSep 7, 2018critical-care-er-observation-scuclinical forms
CLI.4510.SG.005.FORM.02Adult Sepsis and Septic Shock Chart AuditSep 5, 2018across-hospital-unitsclinical forms
CLI.4510.SG.005.FORM.01Adult Sepsis and Septic Shock Standard OrdersSep 5, 2018across-hospital-unitsclinical forms
CLI.4510.SG.005Adult Sepsis and Septic ShockSep 5, 2018across-hospital-unitsclinical
CLI.6611.PL.002Surgical Safety ChecklistAug 15, 2018perioperativeclinical surgical-unit-same-day-surgery
CLI.6410.PL.010.FORM.01Specialized Personal Care Home Environments Wait List ReportAug 14, 2018personal-care-homeclinical forms
CLI.6410.PL.010Specialized Personal Care Home EnvironmentsAug 14, 2018personal-care-homeclinical
CLI.5110.PR.012Discharge Instructions Emergency DepartmentAug 13, 2018critical-care-er-observation-scuclinical
CLI.5110.PR.012.FORM.01Discharge Instructions Record Emergency DepartmentAug 13, 2018