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Implementation Committee: June 5, 2019

In Attendance: Shelia, Kelsey, Jasmyn, Jeff, Alexia, Chelsi, Sarah, Krista, Sandy, George, Kim, Meredith

Regrets: Dayna, Josette


Action Items:

  • Develop post-training survey to REDCAP – Jasmyn

  • Send Jasmyn post-training survey – Alexia

  • Connect with Jeff regarding the on-boarding implementation phase –Chelsi

  • Add to Steering Committee Agenda – Chelsi

  1. Suicide training for assessments – ASSIST

  2. SEE post training calls

  3. Timeframe of consent and baseline assessments

  • Connect with PSSP regarding next steps and Alan Cudmore – Chelsi

 

Minutes

Site Updates/Follow up items from Project Team Call

SEE Post-Training Calls

  • Durham’s SEE Clinician is leaving soon and they are hiring a new staff (though this staff may not be in the SEE Role – may have to have external community services fill the SEE role)

  • Niagara – SEE worker is leaving in July, though their OT will be returning in October that will be in the SEE role.

  • The SEE post-training will continue as usual, and will add this item to the Steering Committee agenda for next week

Survey Regarding Post-Training Calls

  • Jasmyn to add survey into REDCAP to make it consistent

  • We should wait until we send it out due to the fact that some NAVIGATE roles only have had 2 calls.

  • To send attendance to PSSP and the Site Leads so they may be able to monitor their staff.

On-Boarding the New Sites

  • Created different phases of the project

  • Please see attached document with a brief summary of the phases

  • PSSP working on the implementation section

  • Youth/Family Advisory Committee

  1. The members have had to finished EPI services or soon to be discharged

  2. They will provide input on understanding things from a formal perspective and address needs from the population/how can it be sustained. Not giving input on the actual NAVIGATE framework

  • Training

  1. Working with Education Services to disseminate the NAVIGATE training

  2. Still a work in progress, there may be another in-person training for new sites and those who need to be assessed

  3. Education services are already working on simulations for IRT module 2 as wall as E-Learning for the family modules

  4. Effect on the implication outcomes if they are training in different ways

  • Implementation perspective

  1. Looking into the fidelity piece for the non-research sites.

  2. What is generally helpful to the sites in regards to implementation so we can add to the on-boarding process – need to get the site’s perspectives

Durham Site Visit – Patient Measures and Outcomes – Logistics Planning – June 3rd, 2019

Clinic Space and Booking

  • There is a shared room available for patient assessments. It isn’t used that much, and will have all of the technology we need.

  • We need to book the room about a week in advance

  • We can contact the secretary (Carol Perry) in order to book the space

  • We can book clients around their clinic appointments.

  • Carol can book the room for after their consult (initial consult is typically with IRT clinician and physician)

  • At the consult, the clinician will do the verbal referral to research, and fill in the survey. If the client is interested, they can then meet with us right away, and a clinician will walk them over to the room/set them up. This way would be easiest for the clinical team.

  • Clients are seen weekly/biweekly/monthly (it varies). Some clients are only here to see a psychiatrist (not receiving NAVIGATE) – we wouldn’t recruit them

  • Clients can also come in not around their clinic appointments, as long as we book the room in advance. A clinician or secretary will set them up in the room.

  • Client appointments are booked about a week in advance, and clients are typically given their next appointment information at the end of their appointment

  • Clients’ first consults are typically about an hour long, with the psychiatrist and an IRT clinician. They won’t typically have an appointment unless they are accepted into the service.

  • Sarde pre-screens them after referral and gets collateral information to determine this.

  • After referral, the goal is to see them within a week

Research Logistics

  • The clinic is open Monday to Friday, 8:30am to 4:30pm – this is when we could book our appointments

  • Dr. Betlen has a clinic Tuesdays and Wednesdays, 2pm-5pm

  • Dr. Massabki has a clinic Thursday from 9am-12pm

  • The baseline appointment should probably be split into hour-long appointments

  • Most will probably respond best to texting, as the younger clients tend not to answer the phone

  • Sheila doesn’t mind us doing assessments with clients remotely (at their homes)

  • Will they be able to do it on their phones, or does it have to be on a laptop/tablet?

  • Most clients have family drive them to the clinic or take public transportation, Sheila doesn’t see clients getting to the clinic as a major barrier

Communication and Safety

  • They have a safety protocol that they follow in clinic

  • If a client endorses risk to self/others, they will have a psychiatrist form them, and take them to the hospital (or have a family member take them, if willing). If there is an imminent risk or no psychiatrist, they call 911. They don’t have security at the clinic so they would call police/911 if necessary.

  • If we have a safety risk during an assessment, we should call the EPI cell phone, and if nobody picks up, the work extension of a clinician and have them come follow up and follow their safety protocol. If for some reason we can’t get a hold of anyone, we would call 911

  • Is it ok that it’s a clinician (not physician) on their end? For liability, do we also need a physician like we do here?

  • Outside of clinic, we should follow our proposed plan

  • Get addresses so we can call 911 if necessary, have a clinician on-call on our end

  • Follow up with Durham clinical team via email with details

  • In terms of communication more generally, we should try as much as possible to keep in touch (in both directions) about no-shows to appointments

  • They would like a weekly update on clients in research, and are interested in receiving assessment data for their clients for those who consent

Technology

  • Security cable for the laptop is required

  • They have everything else they need to set up the room

Other

  • They receive on average 4 new referrals per week

  • Most of the referrals are accepted, some are referred elsewhere

  • They anticipate it being slower in July/August

  • Concern about research at first visit to clinician: there is paranoia, the clinicians brought up that they might prefer to bring up at a subsequent visit, because they are building relationships with the clients

  • If they bring up at first visit, they think there might be low uptake

  • For people who initially say now, are we re-approaching? For how long/how many visits? How many is realistic for clinicians to keep track of? For how long is it still considered a baseline visit?

  • What can go on the fliers? E.g. can clinicians bring up that there is compensation?

  • Sheila is gone June 9-24


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