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
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
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!
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
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
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.
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.
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!
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
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.