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Project Team Meeting: May 6, 2020

Updated: Sep 1, 2022

ACTION ITEMS:

  • Present COVID-19 research measures to YAC for input before REB submissions – Laura/Andrea

  • Follow-up with Jen for update from North Bay – Andrea/Dielle

  • Follow-up about orienting Niagara peer support worker to research – Abanti/George


MINUTES

REB and Contracts

  • Lakeridge contract signed and executed

  • Submitted amendments to Lakeridge and North Bay in April, currently following-up

Family and Youth Advisory Committees

Fidelity Discussions

  • Janet and the Implementation Evaluation team attended April meetings and discussed baseline Fidelity

  • FAC and YAC had many great questions discussing this important work, and are welcoming the team back to this month’s meetings

  • The committees are interested in hearing about programs’ strengths, how the results will be used

Members & Representation

  • FAC now has representation from all sites and another member joining this upcoming month

  • YAC currently has 4 members, still seeking representation from all sites – please refer any interested youth who have completed EPI services!

Implementation

Core Components Document

  • The document is nearly finalized and plan to share it next week at Steering Committee

Fidelity Assessments (Newest Sites)

  • Currently working with Sudbury to schedule assessments

  • Waterloo-Wellington is now ready to begin

  • Still need to determine whether North Bay can begin

COVID-19 Specific Suggestions for NAVIGATE Delivery/Remote Assessments Document

  • This document was sent to Education Services and will be released by end of week. The document is broken down into different roles, COVID-specific aspects of remote care.


Patient Measures and Outcomes

Recruitment Update

  • The graph below displays our recruitment progress.

  • A total of 10 unique referrals have been received from North Bay and Durham, and 6 participants have been enrolled.

  • We are currently waiting to hear back from 3 participants to be scheduled.



Adding COVID-19 Measures to Research Visits

  • This only applies to research visits and does not impact NAVIGATE/clinical care

  • The measures are being adapted from another study, will need to be submitted to REB

  • REB amendments are currently prioritizing COVID-related submissions

    • Once we have a draft ready, we will get input from the YAC before submitting

    • Including these measures may require an additional research visit

    • The measures include questions about social isolation, resilience, and impact on life

    • This is a unique opportunity to understand impact of pandemic on people’s lives who also have psychosis

    • There is variation in how young people with psychosis may respond to this pandemic

    • These additional measures will help identify factors that may contribute to changes in symptoms/functioning during this circumstance

    • We collect symptom and functioning data every 6 months, so we will get a longitudinal picture

Important: Sites should continue to present research opportunity to clients

  • Clients are more isolated now and this is a unique opportunity to be socially connected

  • Research visits allow an additional check-in with clients, beyond their regular clinic visits

  • Subjective feedback getting from patients is that they like being in touch

  • This is also income-generating opportunity for people to participate.


Update from Site Leads

Sudbury

  • Now asking clients if they prefer to be seen at clinic to overcome connection difficulties

  • Currently have clinic space that allows for social distancing, so can engage safely

  • Continuing to work on processes and things are going well

  • Question: there are research measures to understand impact of care on clients, but what about the impact that NAVIGATE has on the program?

o The Fidelity assessments a) use measurement tools to show how NAVIGATE could help improve fidelity to EPI standards at each program, and b) there will also be interviews with some clinicians to understand the supports needed and challenges experienced.

  • Research Timeline: moving very close, next step is engaging in the Fidelity assessment. They have new clients on board that would be interested in engaging in the research piece and are getting close.

Waterloo-Wellington

  • Clinicians are using NAVIGATE material, each role is at different stage of implementation

  • Feedback: the impact on team dynamics/experience when applying NAVIGATE has been an interesting observation and should be captured in the outcome measures

  • Currently trying to apply the material virtually

  • Question regarding whether tools for prescribers provided are sufficient

o The tool is outlined in the prescriber manual

  • o For medication symptoms, CAMH uses tablets for patients to fill surveys while they wait for psychiatrist appointment. Then, the psychiatrist just has to complete their portion during the visit and the output can be pasted into the EMR. George is happy to share this resource with sites.

Niagara

  • Telemedicine is now up and running for most staff, patient visits done over phone

  • Everyone is still doing IRT, SEE, Family and sending electronic versions to clients

  • Currently in a staffing crisis (short 2 staff), not able to take on much more right now

  • Peer support worker is available for more work, could get involved in research!


Durham

  • Calling clients by phone, using Microsoft Teams for staff meetings

  • The only patients being seen in person are those that require injections

  • Additional restrictions are in place because the clinic is part of an acute care hospital

  • SEE worker is helping with resume writing and practicing interviews

  • Lots of staff turnover; brought back a retired RN, and hired another RN who cannot be released from their inpatient job yet

o Also, do not currently have a peer support worker (they left in January)

  • Was meeting with all clinicians 1:1 monthly to get updates on NAVIGATE but can`t right now because too much going on

o Clinicians send email summaries instead

  • Case load is very high, over 36 patients

  • Getting lots of referrals, especially for patients with cannabis use

North Bay

  • 7 new referrals since January

  • Most visits are done by phone so sometimes it is easy to forget offering the research piece

  • Current caseload is at 27, with 2-3 discharged

YAC Feedback: virtual care through phone is still valuable and a therapeutic alliance, some people may even prefer not having to come in.


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