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Implementation Committee: March 20, 2019

Attendance: Alexia, Josette, Sheila, Dayna, Sandy, Kelsey, Nandini, Jeff, Janet, Christine, Eva, George, Sarah, Chelsi, Jasmyn


Action Items:

  • Get site staff feedback on the clinician contact forms – not ready for production yet

  • What would be most helpful for documenting? REDCap vs. Paper based

  • Remind site staff to complete the in-person training evaluation

 

Minutes:

Introduction:

  • Provide updates around how each site is proceeding and what the implementation team is providing to the project.

  • A way to internally coordinate

Updates from the Sites

Durham – Kelsey/Sheila

Updates

  • In the process of co-developing implementation timeline

  • In process of mapping out ‘service user journey’ for both pre and post NAVIGATE implementation

  • Mapping out referral process and general information/administrative flow

  • Staffing composition for pre and post NAVIGATE implementation – staff are good with their NAV roles

  • Sheila to connect with individual clinician on a one-on-one basis to discuss how they will implement NAVIGATE

  • Team meetings are Mondays from 10:00-11:30 where Sheila has implemented the NAVIGATE team rounds format based on the director’s manual.

  • Full launch of NAVIGATE will be April 1st

  • Kelsey to attend the first team rounds on April 8th

  • Pending REB and documentation alignment

Staffing

  • No role splitting – Launching NAVIGATE as of April 1st for any new intake clients

  • One IRT staff to take care of all new in-takes (Sarde)

  • Two RN will take on family role and give all the injections

  • There is buy-in from the SEE and Family clinicians

  • Jeff is now on a year leave and Allison is taking over for him

  • Colin (IRT) may have some difficulty with adapting NAVIGATE

  • Post training calls will help with this and when his peers share their NAV experience

  • Sarde uses it in a very matter of fact way – though it does seem awkward at first to use because it is in a very structured format

  • Booster calls – the CAMH staff say that it starts off awkwardly but then it becomes natural –

  • TIP: To ensure a use of an agenda as sometimes it can fall off the schedule. Setting an agenda with the patient for the next appointment following NAV modules

North Bay – Dayna/Josette

Updates

  • Working with Julie and Amanda (clinical team) on laying out current client and information flow within the program

  • Most is done virtually, though Dayna going in-person next week

  • They have a strong communication plan and meeting schedule

  • Dayna meets regularly (weekly) with the clinical team

  • Dayna meets biweekly with physician Dr. Primeau

  • Julie and Amanda are generally more comfortable with the materials

  • Embedding NAVIGATE in clinical rounds and intergrading NAV with meetings incorporating Dr. Primeau

  • Not much concerns with implementing the details

Staffing

  • There are separate individual roles, though some role splitting down the line is going to happen in case one of the clinicians are sick as a back up

  • There workload has doubled due to the number of new intakes

  • Current focus is on how to divide the work in the most efficient manner while implementing the modules in their current practice. Also looking at it on an organizational level

  • Creating a care pathway to explain the fluidity of the program – talking about what that can look like

  • Discussion around their

  • Guest log-in at their main site

  • Not sure at the moment what it looks like at their other sites

  • MOU with their community partners – How do they want to formalize their role?

Niagara – Sandy

Updates

  • No contact with the sites last week due to March Break

  • A closed family group starting this week – they are going to use the entirety of the Family modules to guide the sessions

Staffing

  • Conversations about barriers

  • 75% of their work is in the community, therefore it is hard to find a time to meet with the staff in person

  • Staff are feeling positive and want to dive into NAVIGATE at the end of March now that everyone is back from March Break

  • Examination of roles to determine which roles can or should be split/combined

  • Conversation about community partnerships, specifically with the SEE role

Evaluation Update

  • Fidelity assessments are close to completion in Niagara. Data collection is completed in North Bay. On hold for Durham due to the pending contract signature.

  • Readiness survey to go out very soon, link to be sent to every team member. We ask to encourage site staff to complete it when it’s sent out

  • In-person training evaluation has been sent out and there has been a low response rate. Please encourage site staff to complete it, so that we can improve out training.

Clinician Contact Forms: REDCap

Clinician Contact Forms for SEE and IRT clinicians

  • Intended to be completed by clinicians to have contact with patients and to guide the delivery of the content and documentation for the progress notes

  • Challenge: different ways of taking thorough notes

  • At CAMH a copy of those forms are in REDCAP as a survey

  • Clinicians can fill out the survey on a tablet or computer

  • Then after submitting the survey, they receive a summary to then put in the chart

Clinician Contact Forms for Family clinicians

  • Family clinicians do not have these contact forms in the NAV manual but rather they have an education fidelity scale

  • We are going to adapt that fidelity scale so that it mimics the SEE and IRT contact for – building it out in REDCap

  • Family Groups

  • Each family member attending the group would need to fill out the form

  • It would include free text boxes and tick box options – making it easier to communication among the different NAV role team members

  • Are they able to share the links? Not ready as of yet, looking for feedback.

  • REDCap vs. Paper Based

  • Different sites use different methods/documentation as their point of contact

  • From reporting perspective the best route may be through REDCAP as it saves time on data entry then it also provides reports to the site leads; incorporating fidelity of implementation and the sustainability phase of this work

  • What would be most helpful for documenting?

  • Unsure need to talk to the team – Josette and Sheila

  • For the site leads and PSSP specialists to the links back to the team to try out and get staff input as well

Preventing Identifying Information

  • How do we track this so we know what sites it is coming from and who it implies to without having identifying information

  • Initials?

  • NAV ID?

  • Definitely no names

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