Project Team Meeting: April 1, 2020

Attendance: Andrea Alves, Abanti Tagore, Laura Grennan, Alan Cudmore, Anne-Marie Baker Devost, Augustina Ampofo, Dayna Rossi, Dielle Miranda, George Foussias, Gord Langill, Jeff Rocca, Jen Bertoni, Kerri Bennett, Josette Morin, Nicolle Plante-Dupuis, Tallan MD, Alan Cudmore, Augustina Ampofo, Dielle Miranda, Dayna Rossi, Lisa Brown, Mary Hanna, Melanie Barwick, Nicole Kozloff, Sandy Brooks, Victoria Villanueva, Janet Durbin, Sheila Gallagher, Diana Urajnik, Lauren Caruana, Victoria Villanueva, Aristotle Voineskos, Sarah Bromley

Regrets: Avra Selick, Vasanthi Srinivasan, Amanda Ferrell, Don Addington, Catherine Ford, Sara Traore, Anne Hayes, Sanjeev Sockalingam, Eva Serhal

ACTION ITEMS:

  • Follow-up with sites regarding safety during virtual visits - Abanti

  • For ECHO, reflect with your teams on how you have adapted/what is or isn’t working – All Site Leads


MINUTES

ADMINISTRATIVE UPDATES

  • REB amendment in progress at CAMH, awaiting replies

o Has not been sent out yet to sites

  • Awaiting final signature from Durham for contracts; the contract department has been experiencing staff turnover

  • Newsletter to be sent out this week

PATIENT MEASURES AND OUTCOMES

Recruitment Update

  • We have still been getting new referrals for research, thanks everybody!

  • Youth Advisors discussed the importance of giving patient’s a voice by offering opportunities to participate in research

  • When scheduling visits, the research team will loop in the referring clinician and a physician on our end


Virtual Visits & Safety

What are sites doing to manage safety?

  • North Bay: all visits are by phone, face-to-face visits are done if someone is in crisis and for LAI’s; no safety concerns

  • Niagara: phone visits except essential face-to-face; cannot stay in clinic longer for research

  • Sudbury: telephone contact/PCVC, LAIs are face to face in clinic one day per week

  • Thunder Bay: rotating schedule of staff in office

ECHO

  • Next ECHO session is April 28th

  • There will not be a traditional case presented at this ECHO

  • Hub members in each role will share how they have been adapting NAVIGATE for COVID-19, and then sites will share and discuss

  • It is important to use this ECHO to take away ideas on how to structure calls/virtual visits with NAVIGATE since there is a lot of variability in care

  • Sites to reflect before this session about what has/hasn’t been working, adaptations made

  • Cycle 2 is set to begin in September

SERVICE MEASURES AND OUTCOMES

  • Currently working on analyses of baseline data from Fidelity reports and surveys

  • Sites have been on EPION email conversation about COVID-19 challenges and solutions

  • Avra will be sending out a weekly summary to collate the different conversations going back and forth through the EPION distribution list

YOUTH AND FAMILY ADVISORY COMMITTEES

  • Last week, the YAC had a great meeting with 7 in attendance

  • Both FAC and YAC have appreciated the sub-committee leads coming to talk to them

  • Dr. Janet Durbin is attending FAC on April 9th and YAC on April 24th

  • Dr. Voineskos expressed how great it is to have youth and family members on this Project Team call, as it is important to get their support and input on how to adapt care

IMPLEMENTATION UPDATES– SITES AND PSSP

  • PSSP has other projects moving to virtual care, and will share strategies with sites

  • PSSP is here to support sites through this transition to virtual care

  • Durham Site Update

o Working from home with Microsoft Teams, meeting virtually on Mondays

o Telephone counselling

o Taking new referrals but on waitlist due to staff turnover

o RN leaving end of April, already hired new RN but won’t start until further notice

o Still encouraging staff to send participant referrals

  • Sudbury Site Update

o Dayna emailed Family clinicians NAVIGATE documents to share with clients

o Dayna will send large SEE and IRT documents using file sharing methods

Question: How are your patients handling the pandemic?

  • Durham: some patients like the telephone contact, others find it difficult. Since clinicians call from a blocked number, often patients do not pick up the phone. So, clinicians leave a message and schedule a time to call back. Clinicians are emailing NAVIGATE materials to their clients. Clinicians also reporting their clients need a lot of support dealing with pandemic.

  • CAMH: staff use CAMH cell phones with unblocked number to tell patients and families they will get call from blocked number. They are providing care with same frequency as before, although some content may be shorter.

o Suggestion for delivering NAV: clinicians set an agenda for the call. The call may not be as long as usual, but try to still have all aspects of regular session.

o Supported Employment and Education (SEE) workers are still doing the introduction and assessment with respect to pre-vocational work like filling out applications/resumé writing/interview skills which can all be done over video.

  • North Bay: Phone contacts are shorter than a regular face-to-face session in most cases and do not have the same structure as before.  It is more difficult to do the Navigate model: modules… and patients generally express wanting to put that on hold until they come back into the office.  Most patients have been stable and doing fairly well

General Discussion

  • Some patients may experience exacerbation of symptoms due to self-isolation and anxiety.

  • Tele-therapy has been useful for a long time and this situation will help improve capacity/refine infrastructure for tele-psychiatry in the long term.

  • Researching tele-psychiatry specifically for psychosis is necessary as well.

o Dr. Voineskos and colleagues are putting out recommendations soon

Question: How are sites able to figure out clients’ communication barriers?

  • CAMH: either the clients are reaching out to clinicians or this was already identified before. Clinicians are problem-solving communication. For new patients, this would usually happen on the first call.

Question: Is Peer Support work continuing?

  • CAMH: Yes, the Peer Support Worker will continue to provide group and do WebEx with patients.

  • Durham: Peer Support person works for Durham Mental Health Service and has been transferred to crisis services, so this position is now vacant.

Thanks everyone for committing to do this important work! Our population has some unique needs and challenges at this time. We are doing all that we can to keep ourselves and the people we care for safe. The things we learn now will help to provide quality care going forward and after the pandemic.

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