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Project Team Meeting: June 3, 2020

ACTION ITEMS:

  • Add agenda item to discuss early implementation challenges among site leads for Implementation meeting next week - Dayna

  • Coordinate schedule of ECHO Hub facilitators - Abanti

  • Follow-up with Niagara Peer Support Worker about research - Abanti


MINUTES:

Administrative: Study Progress Updates

  • The CIHR Report draft was circulated to the Steering Committee for review

  • Dielle will circulate the budget report to Steering Committee next week

  • Dielle met with Thunder Bay regarding contracts to begin patient measures – we are excited to have Thunder Bay for this outcome measures

Implementation – NAVIGATE Delivery

Durham

  • Dayna and Abanti attended team meetings to encourage client referrals for research

  • Previously, clinicians were concerned about whether patients were appropriate for research but Sheila encouraged them to let clients and research team make those decisions.

  • Note: All clients that enter EPI programs are eligible for the research study, important to give them autonomy to decide.

  • Will start keeping track internally of how many clients are asked about research and their responses.

  • The team is very busy and adjusting, previously doing telephone counselling but adding video with MS Teams this week.

  • Received Fidelity assessment and meeting with Evaluation Team to review on Monday

Niagara

  • 27 clients are receiving NAVIGATE, most care is still virtual and the clinic is still short on staff

  • Next week will see clients in person for metabolic monitoring; psychiatry will remain remote

  • Clients will be properly screened for COVID before being able to enter the clinic; the clinic is attached the public health unit

  • Hoping that peer support worker on the team will be able to help out with recruitment; Abanti is setting up a meeting

North Bay

  • The case load is high: 30 clients with 4 new referrals recently and may get a transfer from Halton program

  • Staff change: currently have an interim manager

  • Delivery of NAVIGATE has remained consistent, via phone with clients coming in for injections

  • Abanti and Dayna met with team to discuss recruitment and 4 North Bay clients are currently enrolled in the research study

  • Clinicians will discuss challenges and barriers to recruitment with research team this month

  • Clinicians expressed some concern with asking clients about research too much, YAC gave feedback that clients want to be asked about these opportunities

Waterloo

  • Meeting with research team on June 10th to discuss research process and outcome measures

  • 32 clients have received NAVIGATE components as the team gets up to speed

  • Before NAVIGATE, clients did not have a formal way to review treatment; it would come up informally and during crises. With NAVIGATE, there are treatment overviews occurring on a monthly basis since case load is high with 180 clients.

  • Each staff has been designated to lead on one of the NAVIGATE modules and will be teaching modules to each other.

  • Note: as staff teach each other and encounter challenges, these will be great topics to discuss during the bi-weekly ECHOs.

  • Waterloo team has notified Abanti that they have scheduling conflict with ECHO as Tuesdays are fully booked.

  • In this early stage of implementation, clinicians are expressing the high demand/additional time commitment that learning NAVIGATE requires

  • o This will be addressed at next week’s Implementation Call – as first wave site leads can provide insight/tips

PSSP Update: Implementation Supports

First 3 Sites: Durham, Niagara, North Bay


  • Current focus has ranged from support being more hands-on to keep momentum up and support clinicians as they adjust to virtual care, whereas others have requested less based on the need.

  • All sites are successfully using the NAVIGATE model as business-as-usual care.

  • Goals are moving sites to Full Implementation and identifying the early stages of sustainability planning.

  • Currently in the process of adapting internal project tracker, to ensure that the implementation story is being captured in the most meaningful and efficient way. 

Main areas of support at these sites:

  • Orientation to changes in organizational leadership

  • Onboarding new clinicians

  • Providing targeted 1:1 support as needed at all levels of the organization

  • Reviewing recommendations within the fidelity reports to address quality improvement.

  • Coaching activities currently focusing on research participant enrolment.

Second Wave of Sites: Sudbury, Waterloo-Wellington, Thunder Bay

  • All new sites are currently utilizing the NAVIGATE model with their clients.

  • Have adapted each new site’s unique coaching plan to keep all areas of a program on track and moving forward

  • Also supporting site leadership/clinical teams to address obstacles and identify alternatives, and celebrate successes as they occur.

  • Pandemic has impacted certain sites more than others, and timelines/focuses within those coaching plans have been modified as a result – certain sites have increased capacity, whereas others less so.

Main areas of support at these sites:

  • Continuing to engage to keep momentum up during the challenges of the time

  • Adapting resources to fit the identified need of a program

  • Supporting the development of group material and supporting the initiation of the research component of the project.