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Project Team: January 6, 2021




Attendance: Andrea Alves, Brannon Senger, Tallan Byram, Nicolle Plante-Dupuis, Augustina Ampofo, Carol Maxwell, Al Cudmore, Dayna Rossi, Lillian Duda, Lauren Caruana, Lauren de Freitas, Josette Morin, Sheila Gallagher, Kim Hewitt-McVicker, Janet Durbin, George Foussias, Ian Speiran, Jeff Rocca, Monica Choi, Sandy Brooks, Sara Traore, Nicole Kozloff, Rameiya Paramalingam, Aristotle Voineskos, Victoria Villanueva, Sarah Bromley, Maurey Nadarajah


ACTION ITEMS

  • Determine site physician availability, discuss strategies for increasing engagement with NAV at Implementation Call – PSSP

  • Explore hosting a webinar about best practices in virtual care to engage physicians – Dr. Kozloff/Andrea

  • Share the Family Advisory Committee video with clinical teams/families to show impact of NAV – Site Leads


Admin/REB

  • The research team is currently in the process of submitting an REB amendment to

  • Text participants for scheduling/appointment reminders

  • Provide family members with option to consent online instead of setting up a video-call

  • We will ask FAC for feedback about this at next meeting before submitting


Patient Measures/Recruitment


Year in Review

  • In 2020, we received a total of 81 referrals and enrolled 40 participants

  • (Note: sites started referring at different points throughout 2020 based on their NAV implementation dates)

  • Of the 41 referrals not enrolled, 11 were scheduled and either did not show or pending reschedule. Remaining referrals have been difficult to contact and sites have been very helpful at checking-in with clients and advising the research team.

  • Sites often share concerns around the timing of asking clients about research, want time to build rapport before asking

    • E.g. at initial appointment it can be overwhelming for client, client may be in crisis

    • As clients are being oriented to NAV, sites can “plant the seed” and let clients know the program is part of this project. This provides context for a future discussion about research.

    • Early on, sites may still need to determine whether referrals are suitable for EPI or need other service

  • The reason that this research study enrolls clients within their first year of NAVIGATE is because we follow them for 2 years to see how they are doing over time.

  • Waterloo staff aim for at least 1 referral per week, and will communicate with research team about when they ask clients

  • For some clients, research can help build clinical engagement because of more consistent check-in, providing feedback, and feeling part of a larger team.

  • We have also heard feedback that clients enjoy exploring their symptoms/functioning in a systematic/thoughtful way during research appointments.

  • Thunder Bay has found that it is helpful to introduce the research as they are orienting to NAV, and the script has been helpful. For some clients, it has definitely been important to wait a little bit.

Site Updates and Feedback

  • Congratulations to Sheila and best of luck in her new director role! Durham will be hiring for a new manager and we will onboard them to NAV.

  • Durham experiences somechallenges around very high case load and NAV implementation, as a portion of clients are from pre-NAV, meanwhile other clients get full or part NAV.

  • At CAMH, once a larger proportion of clients started receiving NAVIGATE, it helped to achieve that sweet spot of regular practice.

  • There is a need address resistance and get psychiatrists on board with NAVIGATE so they can influence other clinicians to adopt it.

    • One way to engage psychiatrists could be to host a webinar on best practices in virtual care

    • Currently, Durham psychiatrists are seeing patients virtually/over phone and are transferring to a new EMR system, so this topic will be good timing for them


ECHO

  • Going well and had 17 sessions in 2020 trying to be very receptive to feedback to improve sessions

  • Feedback on surveys after each session has been consistently positive, and we review all comments

  • Does the timing of these sessions align with physicians’ schedules?

  • Even if having them attend every session is not achievable, can we engage them in other ways like evening webinars?

  • Durham physicians are only available during times they are in clinic and book clients back-to-back on Fridays

  • Funding has been a limitation, we do provide CME credits

  • Follow-up on physician availability at sites at Implementation Call and try to come up with a strategy and timeline to improve this.

Upcoming Sessions

  • Jan 8th: Mood Disorders, case presentation by Sudbury

  • Jan 22nd: Substance Use – Focus on Cannabis, case presentation by Waterloo


Advisory Committees


Family Advisory Committee

  • FAC had a busy 2020:

    • Janet and team discussed Fidelity assessments and the FAC provided input, looking forward to seeing results from the next round!

    • The group provided a lot of feedback on recruitment numbers and strategies

    • Members have volunteered to attend some site family education groups to talk about research involvement and encourage people to participate

    • Some members (Stacey and Nicolle) have also been attending ECHOs and find it helpful to hear how NAV is being used

    • FAC created a video to share with sites why they think NAV and the research is important

    • FAC has grown: some members have joined and others have left

    • The newsletter has been a great way to communicate and keep everyone informed about project progress

    • Would like to review FAC engagement/survey feedback with Simone

Youth Advisory Committee

  • YAC will be meeting at the end of the month to create two videos



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