|
|
|
|
|
|
|
|
Workload Template
|
Date Submitted: |
Month123456789101112 Day1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 |
|
|
Submitted by: |
|
|
|
Cancer Service Cancer Centre |
|
|
Hospital: |
Bulkley Valley District Hospital, SmithersBurnaby Hospital, BurnabyCampbell River District Hospital, Campbell RiverChilliwack General Hospital, ChilliwackChowichan District Hospital, DuncanCranbrook Hospital, CranbrookEast Kootenay Regional Hospital (Dawson Creek)Fort St. John Hospital, Fort St. JohnKootenay Lake Regional Hospital, NelsonLions Gate Hospital, North VancouverMills Memorial Hospital, TerranceNanaimo Regional General Hospital, NanaimoPenticton Regional Hospital, PentictonPowell River General Hospital, Powell RiverPrince George Regional Hospital, Prince GeorgePrince Rupert Regional Hospital, Prince RupertRichmond Hospital, RichmondRidge Meadows General Hospital, Maple RidgeRoyal Columbian Hospital, New WestminsterRoyal Inland Hospital, KamloopsShushwap Lake General Hospital, Salmon ArmSt. Jospeph's Hospital, ComoxTrail Regional Hospital, TrailVernon Jubilee Hospital, VernonWest Coast General Hospital, Port Alberni |
|
|
|
|
|
|
Period Number |
12345678910111213 |
|
|
|
|
|
|
Non-BCCA Registered Patients |
|
|
|
1. New patient coordination |
|
|
|
;)
|
|
|
|
BCCA Registered Patients |
|
|
|
1. New patient consultation |
|
|
|
2. Parenteral chemotherapy |
|
|
| a) 1st parenteral chemotherapy start |
|
|
| b) 2nd and subsequent chemotherapy visits |
|
|
| 3. Oral and hormonal chemotherapy |
|
|
| a) 1st treatment visit |
|
|
| b) 2nd and subsequent Visits |
|
|
| 4. Ambulatory Care Visits |
|
|
|
| Note: This form is to be used in conjunction with the 2003-2004 outpatient workload definitions for Community Cancer Services |
|
|
|