Hazardous Medication Alerts for Ambulatory Patients

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• KNOWN Hazardous Medication Storyboard Alerts

As previously posted, an alert was recently introduced in Connect Care to identify non-ambulatory patients receiving hazardous medications, as phase 1 of integrating hazardous medication identification into Connect Care. As of August 26, 2025, phase 2 has expanded the KNOWN hazardous medication alert to ambulatory settings.

• The KNOWN Hazard Medication Storyboard Alert informs healthcare providers that the patient has received a KNOWN hazard medication, and they are within the precautionary period. This alert enables healthcare providers to be aware that PPE will be required based on the task they are performing. 
• Providers should consult the AHS/COV Hazardous Medication PPE Guide to determine the type of PPE required.
• The alert will appear on the patient's Storyboard given one of the following scenarios:
• A KNOWN hazard medication has been administered on the patient’s MAR.
• A KNOWN hazard medication is identified on the patient’s home medication list.  
• The alert will remain active until: 
• the indicated precautionary period has passed (if the medication was administered through the MAR); or
• the medication has been discontinued, cancelled, or expired. 

The Provincial Hazardous Medication Committee (PHMC) plans to send out a survey in the fall to allow healthcare providers to provide their feedback on the alert and whether the alert meets their needs, especially those who do not have access to the MAR. In the interim, any questions about the alert can be sent via a Service Now ticket.

For more information, see:

• FAQ: KNOWN Hazard Medication Storyboard Alert
• Insite: Hazardous Medication Handling
• Contact: hazardousmedication@ahs.ca 

UPDATED: Hazardous Medication Alerts for Non-Ambulatory Patients

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Hazardous Medication Storyboard Alerts

On May 5, 2025, an alert in Connect Care was introduced to identify patients receiving hazardous medications. This alert was available to inpatient departments and multi-function departments that serve both inpatient and outpatient contexts. Since the alert was launched, feedback has been received requesting streamlined workflows, reduced alert fatigue, and visibility of the KNOWN hazard medication alert in non-encounter views. 

As of August 6, 2025, the following changes will be made to the hazardous medication alert:

• Storyboard will now display only KNOWN Hazard Medication alerts, visible in both encounter and non-encounter views (click the camera icon to see screenshots). 

• POTENTIAL and REPRODUCTIVE hazard medication alerts will no longer be identified on the Storyboard.  
• When handling blood or body fluids from patients receiving POTENTIAL or REPRODUCTIVE hazard medications, refer to the AHS/COV Hazardous Medication PPE Guide to determine the required personal protective equipment (PPE).
• For patients admitted to inpatients and who had received a KNOWN Hazard Medication at home or in the community, the system will use the admit date as the assumed last dose date to calculate the precautionary period timeline.

KNOWN hazard medication alerts will remain active until: the indicated precautionary period has passed (if the medication was administered through the MAR); the medication has been discontinued, cancelled, or expired (by a patient report or an authorized community prescriber); or the admit date to calculate the precautionary period has passed. Non-prescribers will continue to be able to see the KNOWN, POTENTIAL, or REPRODUCTIVE hazardous medication alerts in other locations, including lab specimen labels. 

This change is phase 1 of integrating hazardous medication identification into Connect Care; phase 2 will expand identification to all other departments, with implementation planned for a future date.

For more information, see the FAQ:

• FAQ: KNOWN Hazard Medication Storyboard Alert

Updates to Storyboard Airway Alerts

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Airway Alerts on Storyboard

As of November 26, 2024, the previous “Difficult Airway” line item in the Storyboard will appear as “Airway Alert” to be more inclusive, and will defaults to orange in colour. When hovering over the Storyboard Airway Alert, you will be able to see all historical documentation for the alert (click the below camera icon to see a screenshot). 

A tip sheet details how to update the criticality of the alert and how to remove it, and a guide is available for anesthesia providers on how to document a difficult airway. 

• Tip: Storyboard Airway Alert
• Guide: Anesthesia Provider - Difficult Airway

Advanced Care Planning and Goals of Care Designation Updates

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Advanced Care Planning and Goals of Care Designation Updates

To better support clinical decision-making in the moment and reduce risks of harm when using out-of-date information, as of October 16, 2024, Advanced Care Planning (ACP) and Goals of Care Designation (GCD) related updates have been made to the following three areas:

• Storyboard ACP/GCD status messaging: Adjusted to read “No active order; search scanned docs” when no active order exists.
• Best Practice Advisories (BPAs): Amended to include three additional lines of instruction and link to the ACP navigator (via the “Review ACP/Greensleeve Documents” link at the bottom of the BPA), to instruct on appropriate review of documents.
• GCD Order: Includes additional wording directing users to take appropriate action for ACP/GCD reconciliation: “Green Sleeves and Connect Care must be reviewed and reconciled to ensure that both sources reflect the most recent order. Goals of Care Designations ordered in Connect Care must be printed and added to the front of patient’s Green Sleeve. If any prior printed designations are retained, they should be marked 'VOID', dated and initialed." 

For more details about GCD, see the Connect Care Manual. If you have any questions, contact ConversationsMatter@ahs.ca.

• Manual: Goals of Care Management
• Manual: Goals of Care Designation Definitions

New Pediatric Dosing Weight BPA

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• New Pediatric Dosing Weight BPA

Accuracy in dosing weight is critical for patient safety and effective treatment. To support clinical decision-making by ensuring accurate dosing information, a new Best Practice Advisory (BPA) notification will fire for prescribers to help identify pediatric patients who are <1 year old with a dosing weight recorded on the current encounter and the most recent recorded dosing weight is >7 days old. 

Prescribers will see the following BPA options:

• Update Dosing Weight (via flowsheet row in BPA)
• Update Weight (via flowsheet row in BPA)
• Place Order: Update Dosing Weight (NUR792) preconfigured with a comment “Reweigh patient and discuss with Most-Responsible-Provider to determine the most appropriate dosing weight for the patient". 24-hour lockout will be applied to the notification.
• Acknowledgement Reason: “Remind me in 1 hour”

Note: To view the most recent weight and dosing weight recorded, click the wrench icon in the upper right corner of the window and select the “Show Last Filed Value” checkbox (click on the camera icon to see a screenshot). 

For more information on weight-based dosing, see the tip:

• Medication Ordering Tip: Weight-Based Dosing

Glucose Management Tool Improvements

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Glucose Management Tool Improvements

As of September 16, 2024, a new “Glucometer Overview” column is available to add to inpatient Patient Lists, to facilitate review of glucometer point of care testing (POCT) results directly from the Patient List.

This update makes it easier to identify patients who need diabetes medication review and titration, with colour-coded visual cues and logbook formatting of last/current day POCT glucose results as well as last HbA1C. Double-clicking on the column displays the patient’s Glucose Management Report without exiting out of the Patient List. The report will also be updated to have the logbook formatting.

The Glucometer Overview column has to be manually added to a prescriber’s Patient List; see the tip sheet for details. 

• Tip: Glucometer Overview Patient List Column
• Manual: Glycemic Monitoring and Control

Heparin Infusion Order Panel Improvements

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Heparin Infusion Order Panel Enhancements

Protocolled orders can help clinicians manage uncommon health problems when, for example, the most relevant orders are supported with digests of evidence-informed guidance. The use of intravenous heparin infusions is associated with unique risks. As of September 19, 2024, three associated Order Panels are enhanced; infusions for:

• Cardiology indications
• Venous thromboembolism (VTE) indications
• Stroke indications

Prescribers can find the order panels when searching for orders with "heparin" as a keyword.

• Tip: Ordering Heparin Infusions
• Manual: Protocolled Orders

New Cirrhosis Best Practice Advisories

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Rifaximin BPAs

As of March 12, 2024, two new cirrhosis-related Best Practice Advisories (BPAs) have been implemented in Connect Care. Readmission to hospital for patients with cirrhosis is common and, with the added comorbidity of hepatic encephalopathy, the patient’s likelihood of requiring readmission increases. To reduce the risk of readmissions for hospitalized patients taking lactulose for hepatic encephalopathy, the new BPAs suggest ordering/continuing rifaximin with the second and subsequent episodes of hepatic encephalopathy or with lactulose intolerance. 

• Rifaximin BPA - Upon Signing Lactulose Order: This interruptive BPA will fire for admitted patients with an active problem or encounter diagnosis of cirrhosis and/or hepatic encephalopathy, if the prescriber is signing an order for Lactulose and Rifaximin has not been ordered.

• Rifaximin BPA - Inpatient Discharge BPA Section: This non-interruptive BPA will fire for admitted patients being discharged with an active problem or encounter diagnosis of cirrhosis and/or hepatic encephalopathy, if the patient has an active order for Rifaximin. This BPA will continue to display until acknowledged. 

Perioperative Insulin Management Order Set Enhancements

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Insulin Order Set and Order Panel Enhancements

A prior post describes Connect Care order sets that promote Basal Bolus Insulin Therapy (BBIT) best practices, and a move away from legacy intravenous insulin orders. Three Order Sets were recommended:

• "Pre-procedure Management of Patients with Diabetes Mellitus, Adult"
• "Post-procedure Management of Patients with Diabetes Mellitus, Adult"
• "Basal Bolus Insulin Therapy (BBIT), Adult"

These include all related interventions (e.g., appropriate glucose testing), express Alberta's clinical practice guidelines respecting subcutaneous and intravenous insulin administrations, and align with national and international clinical practice guidelines and provincial Glycemic Management Policy suite.

It is recognized that there may be some situations in which intravenous, rather than subcutaneous, insulin therapy is clinically indicated. Accordingly, the pre-procedure Order Set has been enhanced to include an optional panel (which can also be used independently) to facilitate safe ordering of intravenous insulin therapy. 

• Tip: Perioperative Insulin Management Orders
• Manual: Glycemic Monitoring and Control

Cardiovascular Disease Risk Calculator - Enhanced Lipid Reporting

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Cardiovascular Disease Risk Assessment made easy with Enhanced Lipid Reporting 

Enhanced Lipid Reporting (ELR) is a new, easy-to-use, lab-based approach to measure cardiovascular disease (CVD) risk and ensure those at risk get guideline-directed treatment. The Framingham Risk Score (FRS) and Canadian Cardiovascular Society (CCS) Dyslipidemia guidelines have been built into Connect Care, allowing lab reports to provide a CVD Risk score along with treatment recommendations, based on information from a patient’s lab requisition and blood sample. 

The ELR goes to the healthcare provider, Netcare, and patients through their MyHealth Record account with links to patient education resources. This practice improvement opportunity promotes Alberta Screening and Prevention (ASaP) data reporting, continuity of care and patient empowerment. 

To order a CVD risk assessment in Connect Care, use the "Order Inquiry" activity. The search terms "cvd", "framingham", "fram" and "lipid" will all bring up the "Cardiovascular Disease Risk Assessment" test name. When the test is selected, the below pop-up with screening questions will appear.

For more details:

• Resource: Enhanced Lipid Reporting
• Video: Enhanced Lipid Reporting
• Contact: ELR@ahs.ca

Heart Failure Care Path Update - New Score Available

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Heart Failure Care Path - mHFC Score

As of August 21, 2023, a new modified Heart Failure Collaboratory (mHFC) Score will be added to the HF Care Path, to be applied to HF patients with a reduced Ejection Fraction (HFrEF patients; LVEF ≤40%). This score is automatically calculated (higher being better), as a summary measure of adherence to evidence-based treatments known to improve HF patient outcomes. 

How to use

If applicable to the patient, the mHFC Score will be accessible in one of the following ways (see below for link to screenshots):

1. Care Path Best Practice Alerts (BPAs) - just below the treatment summary
2. Care Path Summary
3. Column hover feature in the Patient List
4. SmartPhrase ".MHFCSCORE" 

Please click to see this helpful document with details of the score and Connect Care screenshots: mHFC Score Benefits and Images.

If you have questions, please send to: HF.Pathway@ahs.ca.

Legacy Insulin Order Sets Retiring

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Legacy Insulin Order Sets Retiring

The Connect Care initiative promotes evidence-informed practice, reducing unwarranted practice variation, and harmonizing workflows for multidisciplinary team members. Accordingly, Connect Care's system-wide Order Sets reflect careful design for best possible practice.

A few insulin administration Order Sets were temporarily made available to Launch 1 users, recognizing that some groups had not completed change management for provincially standardized insulin administration practices. All facilities now have the means to follow evidence-informed, cross disciplinary, insulin administration guidelines. Accordingly, the following two order panels will be retired (exact date TBD).

• "IV Insulin - NPO patients requiring low fluid volumes"
• "IV Insulin - NPO patients requiring regular fluid volumes"

Instead, one of the following Order Sets should be used:

• "Pre-procedure Management of Patients with Diabetes Mellitus, Adult"
• "Post-procedure Management of Patients with Diabetes Mellitus, Adult"
• "Basal Bolus Insulin Therapy (BBIT), Adult"

These include all related interventions (e.g., appropriate glucose testing) and express Alberta's clinical practice guidelines respecting subcutaneous and intravenous insulin administrations.

Prescribers remain free to assemble and share personalized order panels for justifiably unique circumstances. However, these must fit with training and supports for all members of the medical team.

COVID-19 IPC Alerts Live

Problem: Patients arriving from non-Wave-1 sites with positive COVID-19 NAT results were not triggering automated infection prevention and control (IPC) alerts.

Solution: The COVID-19 IPC Alert now auto-triggers in Connect Care, even for specimens collected outside of launched sites. This applies across all contexts, including ambulatory care.