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Implementation Committee: June 12, 2019

In Attendance: Janet, Mary, Kelsey, Dayna, Jasmyn, Sarah, George

Action Items

  • Sarah to connect Jasmyn and Susan– Done

  • Jasmyn to coordinate the call with Susan

  • Send post-training calls survey at the end of the summer (mid to late August) – Implementation Committee



Updates from Steering Committee

  • Contract and REB will be submitted to Waterloo Wellington soon, ideally by end of next week

  • The patient measures and outcomes working group is still working on a safety/risk assessment plan

  • This should be developed in consultation with the sites

  • If the clients are at the clinic, we will contact a clinician for them to follow their usual protocol

  • If the clients aren’t in the clinic during the assessments, this process will be worked out further in consultation with the sites

  • We are planning on opening up recruitment into the patient measures part of the study as long as patients are in their first year in the program (not just at their first visit any longer)

  • Open to anyone who joined the program after May 1st of this year

  • The recruitment start date target is July, we will keep everyone updated as to progress

Update Call with Susan and other Trainers

  • Susan’s (NAVIGATE trainer, training coordinator) calls are essentially a check in, to see how things are going, to give feedback, etc. for the calls.

  • The other trainers chime in with their experience from their calls, identify themes, etc.

  • We need to figure out who is on the call with them, and when the call will be

  • Makes most sense for it to be on a Wednesday at this time

  • Is there overlap between this call and the survey about how the post training calls are going?

  • The call with Susan is more for feedback from the trainers on what they’ve been hearing (implementation/clinical capacity gaps), less so how are the calls themselves specifically going

  • It makes more sense to do this call some time in July, not next week

  • Not sure how many of these calls are on the contract for over the year (2-3 maybe?)

  • Trainers, PSSP leads, maybe Alexia, site leads could be helpful to be on the call

  • Could be an opportunity for site leads/PSSP to provide them some feedback around how to make the post-training calls more interactive, how to bring in more group discussion, etc.

  • Mary would like to join call from an evaluation perspective

  • Sarah will connect Jasmyn and Susan to coordinate the call

  • Should be scheduled in July during one of these Implementation Committee meetings

  • The call will be helpful to help identify gaps, strategies, how to support clinician(s), giving general status updates, etc.

  • The intent is to be as helpful as they can, to help problem solve, to reflect on things that have gone well, etc.

Post-training calls survey

  • Consensus was to send out the survey after at least 3 post training sessions had taken place for each of the interventions

  • Prescriber and maybe director calls are outstanding

  • Feedback from site leads: better to hold off a bit, people are building momentum and getting into things

  • Part of this was to flag for attendance, what the barriers might be to attending

  • Sometimes there are other pressing clinical matters as well as opposed to being on a call

  • We will plan to send this out at the end of the summer instead, in mid to late August

PSSP updates about sites

  • There has been a focus on implementing a process for clinical contact data

  • And how are they using it to support care delivery in relation to NAVIGATE

Durham updates:

  • Kelsey met with Sarde to talk about this process, then they met to map out the way things were, identified processes/tasks that needed to be looked at and changed/tweaked or addressed to align with NAVIGATE

  • Meeting again next Tuesday

  • Looped Sheila in, and is reporting back to the team on the work they’re doing

  • They use both electronic and on paper medical record systems (2002 MEDITECH EMR)

  • They will be getting a full overhaul on their EMR system

  • They’ve been strategizing on how to build the clinical contact forms into the clinical workflow

  • Most are using as a prompt but also recording the information in their clinical notes

  • They have their own binders for each client that they keep in their own office, which works as a clinical workbook

  • Prompts are on a sheet of paper next to computer for when writing case notes

  • There were also pieces to work on around the intake process, revamping the intake form

  • For family workers, they weren’t sure how to document the family work

  • Connected with Sarah, looked into family members getting files opened

  • They aren’t able to do that now due to some liability issues, so just high level notes embedded in the client files instead

North Bay updates:

  • Really similar to Durham

  • Changing EMR systems, trying to get contact forms embedded in new system

  • They currently do both electronic and paper forms

  • Bringing paper versions to community, then will put in paper file

  • Moving to paperless

  • Everything on contact form will also be in the clinical note as well as additional collateral information in the client case notes

  • Followed a similar process as in Durham, looked at current processes and what needed to change

  • Have been developing a SEE tracker for them to use since the SEE role is external

  • CAMH SEE worker is also finding this tool helpful

  • Will be helpful as an onboarding tool with shifts in staffing as well

  • For these data to be useful for Service Measures and Outcomes, would they have to do file audits to pull information to learn what’s being delivered?

  • The clinician contact forms aren’t in the EMR, so they can’t run it that way

  • How can Janet get information about how often a client came, what modules they got, etc.

  • Could do a sample chart review of NAVIGATE clients, if people are keeping the form individually in the files then that could be a way of looking at the information

  • A sample of 10 navigate clients, for example

  • Looking at individual contact forms recorded

  • May not be systematically capturing all of this information in one place, besides maybe a SEE role

  • Could in future have an addendum to look back at all clients receiving NAVIGATE and do a chart review

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