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Implementation Committee: April 17, 2019

In Attendance: Janet, Josette, Krista, Sandy, Alexia, Jasmyn, Chelsi, Shelia, George, Sarah, Mary

Regrets: Dayna, Jeff, Kelsey


Action Items:

EPI-SET project team conference call

  • Outlook invite sent for May 6th 9-10am to project team – Chelsi

  • Formulate 5-10 minute summary of progress – Implementation Committee

ECHO calls

  • Confirm ECHO call time with physicians, clinicians, and site leads & send to Chelsi by next week – PSSP/site leads at Niagara and Durham

Draft Implementation Committee terms of reference and bring back to next meeting – Alexia and Janet

  • Determine how ad-hoc trainer calls might fit in

Readiness survey

  • Another reminder being sent today – Mary

  • Tell site leads who received it – Mary

  • Follow up with individuals to let them know to complete it/that a reminder will be sent – Site Leads

  • Connect with Steve to mount/sent the physician survey – Mary

- Follow up with Durham regarding fidelity once contract is finalized – PSSP

- Share family handouts with site leads – Alexia

 

Minutes:

Teleconference call:

  • May 6th, 9-10am

  • Chelsi will send invitation to larger grant members

  • Each committees to formulate a small summary and send to Chelsi (5-10mins per committee)

ECHO calls:

  • 4th Tuesday of the month from 1-2pm, starting in July

  • We have confirmation from Josette

  • Niagara and Durham site leads and PSSP needs to talk to physicians and clinicians to make sure that time works (1h duration for now) and send final confirmation to Chelsi by next week

  • Every clinician, physician and site lead should be on each one of these calls

  • There is a 20 min didactic lecture, then a case discussion on a topic relevant to Navigate

George’s Conversation with Navigate Trainers:

  • George had a conversation with Piper at a recent conference

  • They identified that there is an opportunity for us to have a call with the trainer to see how things are going, and to see if there are ways to prevent some of the struggles that Slaight had, as well as to be on the same page generally

  • Thoughts: a) is this a good idea/worthwhile? b) who should be on the call?

  1. As trainers get a sense of practice at the sites, they can transfer knowledge and perspective over time to the Implementation Group (so we can continue our efforts based on what the trainers have noticed)

  2. Her perspective may be different than ours, e.g. might see some early indicators, possibly based on what she has seen at other sites

  3. Site leads/PSSP could be in this discussion

  4. How often should these calls happen?

  5. Trainers can also email Sarah/George but this way is more direct

  6. The trainers might identify “just in time” info and themes based on what they are seeing here and what they have seen in other jurisdictions

  7. Is it worth exploring them joining the Implementation Committee meeting?

  8. we can propose to Piper but will also depend on her schedule

  9. Let’s try to arrange something for this time, and follow up via email

  10. The call shouldn’t be too soon, but should wait until clinicians have more experience with Navigate

  11. As a group, we can think about how best to use the ad hoc call (she is meeting twice a month with IRT clinicians, they can bring things forward too)

  12. E.g. themes, capacity building to incorporate into ECHOs, etc.

  13. It wouldn’t be her providing implementation guidance, her expertise is the clinical practice piece

  14. A higher level themes-based call with her wouldn’t be redundant with the post-training calls

  • The framework she is coming from is the early resistance here at Slaight

  • It wouldn’t be clinical staff participating in this call – it would be implementation and site leads participating to get a general perspective

  • Maybe in May or June this would be more helpful

  • This week: Alexia and Janet are working on the Implementation Committee Terms of Reference – bring back to next week

  1. This will iron out the purpose and goals of the different parts of this committee

  2. Another thought – maybe site leads don’t need to go to this meeting?

  3. Can fit the call into Terms of Reference and get a sense of the target of the conversation

Evaluations:

Looking to increase response rate of readiness survey sent out 3-4 weeks ago, there’s about a 50% response rate

  • Went to clinical staff, program management, upper level management

  • Will send another reminder email after this call today

  • Please mention to teams including upper level management that a reminder email is coming for this survey – from Mary Hanna at CAMH

  • Mary will follow up with who it should have gone out to at each site

They are about to send out physician survey as well

  • Steve will mount it on to redcap later today

PSSP will complete draft report for Niagara EPI fidelity assessment next week, will review internally before it gets to the sites

  • First report – approx. early May

  • Had consensus rating meeting for North Bay last week

  • The delay is in trying to sort through a tele-fidelity strategy, and there is some variance between the measures being used in different locations, so they are trying to determine which items are the most useful/applicable for the project à they will flag this for sites when comparing this assessment to previous assessments

  • Will follow up with Durham once the contract is finalized

Knowledge exchange:

  • Jeff shared family handouts, will be shared with site leads after this call

  • Sarah and George gave feedback so it should be good to send out now

  • Site leads – if there are other things like this that would be helpful, feel free to mention to your implementation point person in the future (e.g. for other topics)

  • North Bay clinicians really liked it!

Implementation Updates:

Niagara:

  • Mapped out their intake process

  • Have a draft communication for welcoming clients into services, revised based on Navigate

  • Drafted a communication for the intake workers

  • The family group with the social worker/IRT is using Navigate materials, piloting using binders and information to families (who are very open to it)

  • Everyone is trying out using the material with new clients coming in à finding it a little cumbersome sometimes, but that is part of getting oriented to it

  • Some sessions aren’t getting through all the material in the one designated session

  • Went through role definition with Sandy when she came down for the site meeting

  • Team is working really hard at using later modules with existing clients; some clients have been in the program a long time, so it doesn’t make sense to use earlier modules, but they can incorporate later modules

  • There are focus notes in EMR for IRT/case management/SEE

  • PSSP is going to include in the fidelity report what Navigate will help with for each item in the fidelity scale which will hopefully will help with clinicians finding it cumbersome

North Bay:

  • Clinicians usually in first meeting mainly say they have a new model

  • One person says they will do IRT, another says they will do family

  • They don’t know if the client will be accepted into the program at that point

  • Once IRT meetings start, then components are introduced more formally

  • Amanda: doing IRT with 9 clients

  • Some are older clients, some are new

  • Some like the structure, some don’t like the paper work/homework so much; they got good feedback with Piper about this and about how having more discussions as opposed to using formal materials can be helpful

  • -Julie has 4 members that she is starting family modules with

  • She found the initial questionnaire takes a long time (1.5+ hours) so is discussing with Susan about that

  • Things are going well, no formal meetings yet with the whole team, but will start that very soon

  • Total case load is 22

  • Offering flexibility in scheduling is helpful for the family

Durham:

  • Officially launched Navigate April 1

  • 1st week had no new referrals

  • Received 3 new referrals last week à if they are appropriate for the program they will get the full Navigate

  • Jeff is taking 1 year LOA in May but has met with most clients, gave them an explanation about Navigate, gave them copies of some documentation and told them that Allison will replace him and will follow this program

  • Sarde has presented some new information, and clients are accepting positively

  • Clients are struggling with the homework piece, often aren’t filling it in.

  • They are excited about the program and like that they can be assigned a SEE worker

  • SEE have started working with some individuals

  • Family is just putting the program together

  • These are the nurses who do injections, intakes, etc. so they are just putting the group together which will start in May

  • They will do co-therapy but one individual is away for 2.5 weeks starting tomorrow

  • They started to organize the binder and the group

  • Overall – some staff are saying it is “too soon” to start using Navigate and are overwhelmed but as they start using it it’ll probably go better as they get more familiar with it

  • People are starting to see the benefit of separating working with the client from working with the family

  • Sarah: appreciates the sense of being overwhelmed, but it is about mileage, they won’t learn by just reading the manual, they will learn by doing

  • CAMH started to have reflective practice meetings, the site could have lunch and learn to avoid another meeting à this could be a way for some people who are slower to adopt to hear from their peers about trying Navigate, what they did, and how it went

General Items:

  • Implementation Committee is open to hearing site lead agenda item requests if there is something that would be helpful

  • At next meeting we will go through the tracker/project management tool

  • Prescriber calls are the second Thursday of the month (monthly), 12-1pm

  • The call schedule is on the website for everyone

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