Project Team Meeting - March 4, 2020

Attendance: Mary Hanna, Lauren Caruana, Lillian Duda, Sandy Brooks, Nicolle Plante-Dupuis, Anne-Marie Devost, Abanti Tagore, Andrea Alves Laura Grennan, Jen Bertoni, Josette Morin, Al Cudmore, Alexia Jaouich, Kerri Bennett, Lisa Brown, Janet Durbin, Sanjeev Sockalingam, Aristotle Voineskos, Sarah Bromley, George Foussias, Heather McKee, Diana Urajnik

Regrets: Augustina Ampofo, Eddy Nason, Sheila Gallagher


ACTION ITEMS:

  • Set-up an onboarding call with Kerri Bennett and Sarah Bromley – Laura

  • Share documentation templates with site leads – Anne-Marie

  • Ensure that the topic of ‘documentation’ is agenda item at next Implementation Call with site leads – Dayna/Alexia

  • Send names of students to Sarah Bromley so they can gain access to eLearning – Site Leads

  • Complete Doodle poll or send Mary alternate times to coordinate Fidelity assessments – Site Leads

  • Follow-up with each site regarding their Fidelity results when reports are completed – Mary/Janet

MINUTES

PARTICIPANT RECRUITMENT UPDATE

Youth Participants Enrolled: 3 Family Members Enrolled: 1





PATIENT MEASURES AND OUTCOMES

  • North Bay has consistently approached their clients about this research opportunity, but this is not happening at other sites

  • We will revisit this with Niagara and Durham to see if any barriers are in place

  • Asking all clients if they are interested in research ensures equitability and this yes/no question should be part of clinician checklist

  • Niagara has received the research laptop, will be purchasing one for Sudbury


ADMINISTRATIVE UPDATES

Introduction

  • Welcome Kerri Bennett, Niagara Site Lead taking over for Krista. Kerri has been working as a nurse on the Niagara EPI team for 7 years, took on a leadership role with NAVIGATE and has been doing NAVIGATE with her clients.


Contracts

  • Waiting on Durham’s legal team to sign contract, all others sites completed.


REB

  • Newest round of amendments currently being reviewed by CAMH REB; awaiting response.


IMPLEMENTATION – TRAINING

Update from PSSP

  • Niagara is focusing on operational processes now that NAVIGATE has been implemented from a practice perspective

  • The 3 new sites are using NAVIGATE, working on integrating into their programs and developing processes for the research component.

  • PSSP is working with site leads to support these implementation challenges and will be sharing the results and report from their Fidelity assessments


REDCap database

  • Currently in progress, estimated completion date is 1 month.

  • The REDCap database will facilitate Fidelity evaluation and simplify some documentation processes, but longer term EMR solutions would need to be worked out with site ITs (interested sites can contact Sarah for CAMH’s EMR process)

  • The REDCap database will have these features: -- anonymous Client ID numbers (so sites will need to keep their own records to link ID numbers with their client’s info) -- drop-down boxes to easily click which modules were completed

o Note: sites will still need to document their narrative in their EMRs; the REDCap is not made to capture this info


eLearning

  • All sites have received access to the eLearnings.

  • It is also beneficial for students to access the eLearnings so they can know about the model of care


Post-Training Calls

  • Calls are wrapping up but we will continue with once-monthly drop-in calls starting in June to answer clinician questions efficiently

  • The calls will be role-specific and occur at same time as the Post-Training calls, since clinicians have already set this time aside


Updates/Feedback from Site Leads

Thunder Bay

  • Moved clinics in last few weeks and experienced technology challenges

  • New nurse on-boarded for IRT role

  • Jen reached out to Dayna about having forms to hand-out electronically

  • A new intake on Thursday will be receiving full NAVIGATE treatment

  • Currently focused on how to document/chart NAVIGATE; Thunder Bay has 2 electronic medical records (EMRs) which are not integrated and don’t want a 3rdseparate process

  • Discussed possibility of having fillable forms online and a shared drive where NAV clients can link through agency computers

  • What do other sites do for documentation? -- Niagara: use progress notes in EMR to document completed modules and results from handouts, scan attached notes. Can easily search “IRT” to see results like how many sessions client completed. -- North Bay: keeps paper forms and mention NAVIGATE progress in Meditech EMR -- Sudbury: developed templates with consistent language about modules that easily paste into EMR to minimize time spent. Also developed spreadsheet to collect data until the ACCESS database is ready. Anne-Marie will report back on how well this works once full implementation starts.


SERVICE MEASURES AND OUTCOMES Fidelity Baseline Review Presentation by Mary Hanna

  • Please refer to presentation in the link above

  • EPI-SET Fidelity assessment adapted from EPION pilot

  • Sites can expect to receive lower ratings on the EPI-SET Fidelity assessment than they did on EPION pilot because there is a higher bar for good performance using this modified scale

  • Fidelity Scale: 12 items overall grouped based on areas of practice

  • Scoring: 1 aligns with not implemented à5 aligns with full implementation

  • Slide 6 demonstrates that baseline average scores for EPI-SET baseline reviews is lower than EPION pilot, and scores also lower than the other sites in the EPION pilot

  • Slide 7: psychosocial treatment domain received the lowest scores, a lot of focus will be on this

  • Also observed lack of structured program delivery, lack of consistent documentation and evidence of inconsistent offerings between staff

  • Slide 9: importantly, NAVIGATE may help address these challenges

  • Status of reports: Niagara has received final report, North Bay’s is completed but undergoing final edits, and Durham’s is in progress (to be sent out in next 2 weeks)

  • There are 3 rounds of assessments: baseline, 1 year and project end

  • The structural model is in place, the key piece is having all clinicians implement


YOUTH AND FAMILY ADVISORY COMMITTEES UPDATES

  • YAC Meeting this Friday, Dr. Foussias to attend

  • YAC has 2 potential new members, Augustina/Andrea have scheduled calls

  • Thunder Bay discussed whether their Peer Support Worker could get involved with YAC. Peer support workers do bring a different point of view, having both lived experience and being frontline staff. -- We will bring this up to the YAC

  • FAC has 3 new members (2 from Durham and 1 from Waterloo) – still need representation from Sudbury

  • Dr. Voineskos attended last FAC meeting and there was great discussion.

  • FAC was surprised at the low number of participants enrolled in research and are interested in thinking of ways to improve enrollment of both patients and family members.

  • Next FAC meeting is March 12th


IMPLEMENTATION – ECHO

  • Completed 6 ECHO sessions; 15 spokes attended last session

  • Survey completion - Aug: 50%, Sept: 18%, Oct: 42%, Nov: 20%, Jan: 48%, Feb: 67%

  • April Flex Session Topic: tie between A) Cannabis and Psychosis or B) Developmental Delays and Psychosis

  • Abanti is working on CME Accreditation application for cycle 2

  • EPI-SET is pilot for re-numeration for completion of surveys bc response rate went up substantially.

  • We want to evaluate how well the ECHOs are doing, so to encourage completion we have 3 prizes of Amazon gift cards.

  • We are in process of revising curriculum, reiterates the importance of forms. The feedback is taken to inform next round of curriculum to make sure there is enough variety

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