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Implementation Committee: March 13, 2019

In Attendance: Mary Hanna, Jasmyn Cunningham, Christine Mitchell, Sandy Brooks, Kelsey Jones, George Foussias, Sarah Bromley, Chelsi Major, Jeff Rocca, Alexia Jaouich, Nandini Saxena, Janet Durbin


Action Items

Operational

  • Follow up with Durham legal – Dielle

  • In-person training evaluation reminder email (after March break) – Chelsi

  • Share current implementation tracking log – Alexia

  • Find out if North Bay has a guest network – Dayna

  • Make tentative schedule of who comes to which Implementation Committee meetings (e.g. site leads on 1st Wed. of the month?) – Alexia

REDCap

  • Set up REDCap account for readiness survey – Mary (with Steve)

  • Build clinician contact forms on REDCap – Steve

  • Finalize forms/versions to be sent to Steve – George

  • Problem solve how sites want to complete clinician contact forms – PSSP

Study Documents

  • Review documents emailed prior to this meeting, and send feedback directly to Chelsi prior to next week’s meeting – Implementation Committee

 

Minutes

1) Steering Committee updates:

  • Niagara contract needs one more signature, Durham approved by REB but waiting on legal (but needs both for full approval) Dielle will follow up by end of week with a phone call

  • Took a brief look at EPI-SET documents, but will discuss further at this meeting

  • Service User ones will be reviewed in Advisory groups

  • In-person training evaluation, discussion about reminder email – Chelsi after March break

  • PSSP updated about project tracking documents (follow up from discussion last week about tracking log and coaching plans). PSSP has to pick a template for this project for the coaching plan.

  1. To this point has been largely a narrative coaching log

  2. PSSP – will discuss templates at meeting tomorrow

  3. Will start sharing tracking log to see if it is the right level/type of information

  • Readiness survey is in progress

  1. Will come from Mary but be sent directly from REDCap so we can monitor who has responded (without linking to the actual response data)

  2. Mary needs to set up a REDCap account with Steve


2) Updates from sites/PSSP


Kelsey (Durham):

  • Meeting weekly

  • Majority of work: co-developing implementation plan, overlaying Navigate model on their existing processes, determining what changes will need to be made

  • No role-splitting

  • Most work around documentation, working with Sheila and team to switch over administrative processes

  • Have switched team meetings to use Navigate team rounds

  • Have been cleaning up referral process and looking at case loads

  • Meeting with Sheila to debrief after Monday meetings, will attend April 8th meeting (should have Navigate going, at least from an IRT perspective)

  • Largest potential challenge/questions: around employment workers, how they view themselves (both were child/youth workers). There have been switches in their role.

  • Durham is using MEDITECH, how can we streamline things for clinicians?

  1. Each site has their own documentation mechanism, some a mix of EMR and paper, some EMR - the plan is to eventually be all electronic but it isn’t currently

  2. Navigate has template clinician contact forms, and there are forms for workers (e.g. based on family fidelity scale)

  3. We made a similar contact form for all interventions except prescriber - tries to capture whether the intervention was delivered, what module/strategies/techniques were used or covered, etc.

  4. At CAMH there is a survey on REDCap that is a version of this form, where they can select appropriate responses. After they hit submit, it generates a summary of what they’ve entered that they can copy and paste into the EMR for their notes.

  5. They can fill this out on paper then provide us a copy if they prefer

  6. Can they still access REDCap after the study is done? à Part of the thought was to see how useful the contact form is for the sites, and help them build out a system after that is helpful for them. At that point, other solutions will be able to help with sustainability, for example it could potentially be set up as a template in their EMR systems.

  7. Timeline for REDCap - Forms are done, they just need to be the correct versions. Then we can get Steve to share so PSSP can see what they look like/test them out.

  8. Will need to see what preferred practice is with staff soon – scanning them might not be the best use of their time after, and entering them right away might not be feasible. PSSP will do some problem solving.

  9. Forms are similar to what is in the manual, with some mild tweaks to ask about some additional information

  10. If on paper – would need to duplicate some into their note, but with REDCap they can copy and paste into their note

  11. Can also be considered a reflective practice for the clinicians and their managers can use data from it as well to see if clinicians are implementing, and have a conversation about practice barriers

  12. When will link be available to sites? Beginning of April.

  13. Has guest network that clients can use

Sandy (Niagara):

  • Haven’t had a lot of contact with Niagara, met on Friday for the first time

  • Their site has had several suicides since December, and several in the program that Krista is managing

  • Haven’t focussed much on Navigate, brainstormed what they can do right now

  • Family group starting next week, and they are embracing Navigate family module in this group

  • They are mapping out the flow through their program right now

  • Krista is off this week, when she is back she is hoping they can dive into it

  • They are going to set up a regular meeting time once Krista is back

  • They want to figure out what is different in their program currently from Navigate, see where they are at before they figure out what they need to change – they want to understand flow through their program before fully implementing Navigate

  • Has a guest network, and has iPads that clients can use

Mary (North Bay):

  • Dayna is away at a meeting today

  • She tried to find out if guest network is available, Josette isn’t sure, haven’t heard back from Erin but Dayna is meeting with her on Friday

  • She meets with site regularly

  • Will meet with Erin Friday to develop coaching/support staff

  • Will meet with family/IRT staff

  • Julie (family) is gone for the next week or so, so all communication should go to Amanda who is covering for Julie à always send everything to both of them

  • Working on developing MOU between North Bay Regional and PEP (local peer support hub) who will be providing SEE and peer support for Navigate delivery

  • The MOU goal is to establish accountability

  • She didn’t share any challenges at this time

  • Josette, Julie and Amanda are gone March 25-27


3) Include site leads in this meeting?

  • Sarah reached out to site leads this morning

  • Will likely be able to help with communication, identifying problems/hurdles with implementation and to share ideas/solutions

  • Might be able to reduce the burden on PSSP and streamline communication

  • Hearing from site leads first hand could be useful

  • Will we need to be able to have conversations without sites involved? E.g. challenges or barriers at sites. Would that be a consideration?

  • With what frequency should everyone be on the calls? Site leads? Sarah/George? etc.

  • They will also have ECHO once it starts up - though this will be about service delivery and capacity building, not implementation

  • Alexia will make a tentative schedule of who will come to which Wednesday Implementation Committee meetings (e.g. 1st Wednesday of the month for site leads)

4) What would be most helpful for documents?

  • General review of documents – Chelsi, Dielle, and Aristotle went over them to review format, so everyone can review content

  • Everyone take a look and send feedback directly to Chelsi

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