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Project Team: November 4, 2020

Attendance: Andrea Alves, Don Addington, Melanie Barwick, Augustina Ampofo, Dayna Rossi, Kim Hewitt-McVicker - WW, Lauren Caruana, Josette Morin – NB, Tallan Byram, Diana Urajnik, Alan Cudmore, Brannon Senger, Nicole Kozloff, Alexia Jaouich, Carol Maxwell – Thunder Bay, Sandy Brooks, Dielle Miranda, Aristotle Voineskos, George Foussias, Sheila Gallagher - Durham, Janet Durbin, Heather McKee, Kerri Nagy – Niagara, Sarah Bromley


Administrative Updates


  • Contract process nearly finalized

  • Regulatory submissions for EPI-SET and e-NAVIGATE in progress

Staffing Update

  • Hired a new EPI-SET research analyst to join our team – Rameiya will be starting on Monday, November 9th

  • After first few weeks of orientation, Rameiya will take over some aspects of the project, Brannon and Andrea will reduce their extra tasks

  • Also in process of hiring a 4th research analyst

Fidelity – Dr. Don Addington

  • Don recently published a paper about the properties of the 2018 version of the Fidelity scale, which is being used in EPI-SET

  • Inter-rater reliability and feasibility were assessed after Fidelity assessments were conducted at 36 FEP programs in the United States

  • Importantly, the study demonstrated good inter-rater reliability

  • Also showed that the programs that don’t use a structured approach don’t do as well

  • We can compare Fidelity at the component level between the U.S. study and this study or e-NAVIGATE

  • The findings of this paper do not change practice for Fidelity assessments at the sites; it was examining the science of the scale

  • Adding 2 new items to the scale

  • Age range is determined by provincial standards, and we are measuring it now whereas it was not an item before

Site Updates


  • Continue to encourage staff to refer clients for research

  • Will be meeting with nurse that started in September to discuss family worker role

  • Very busy - currently have 14 people on waitlist; previously were taking in all clients within a week

    • Fidelity results had been good in this area before

    • Providing support to patients and families while they wait

    • Hoping to streamline services more with partnerships

    • Referrals are increasing, 80% of clients using cannabis/drug-induced psychosis, bipolar

  • Full-time IRT staff was off on paternity leave, returning next week which should help with waitlist


  • NAVIGATE is the norm; all clinicians delivering NAV with new clients

  • New staff have indicated that NAVIGATE helps them with what to say and how to say it

  • Current challenge: lack of services to discharge clients after 3 years in program. Starting to refer people after 2 years since waitlists are long.

  • Many clients are unwell right now, focusing on ensuring they get resources as soon as possible.

  • So many clients that are unwell right now

  • Trying to ensure they get resources as soon as possible


  • 3 new staff, working with Al to get them oriented to NAV

  • Will take time to get clients transferred

  • Have regular weekly meeting to check in about NAV roles and research which is going well

  • Noticed a bit of positive narrative shift in team, currently in a nice flow and more consistently referring for research

  • Meet with research team each week, team saves questions for research team

  • In a nice flow, more consistency with referring to research

Thunder Bay

  • Continuing to move forward with implementation, meeting weekly with all roles

  • 7 clients have received NAVIGATE – some that started before the launch with certain modules

  • Referred 3 clients for research, and glad to have Andrea and Brannon at weekly meetings

  • Planning to look at collaborative treatment plan meetings for some individuals

  • Getting ready to start Fidelity evaluation process next week with chart extractions and interviews.

North Bay

  • Caseload is 27, and 1 new client referred to the research team

  • Majority of visits are virtual but all clients get the option to be seen in person.

  • New consults always seen via OTN (with psychiatrist and team).

  • 2 new clients have given consent for family to be involved.

  • Delivery of NAV still going well and being well received.


  • Next session: this Friday on Medication Management

    • Didactic: Dr. Wanda Tempelaar

    • Case Presentation: Thunder Bay

  • Leadership transition: Dr. Monica Choi has been in prescriber role on the ECHO Hub since we started and is very familiar with the model.

    • Dr. Choi will start attending the Project Team meetings to hear from the sites about problems you’re dealing with and using ECHO to fill some learning gaps

    • Dr. Kozloff will stay involved in an ad hoc way, if Drs. Sockalingam or Choi are unable to attend

  • A Family Advisory Committee member will be attending the ECHOs going forward

Youth Advisory Committee

  • The Youth Advisory Committee will be creating 2 videos

    • 1 video will be about why the Youth Advisors decided to contribute to EPI-SET and NAVIGATE

    • 1 video will describe their own experiences with psychosis

  • Also working with the Fidelity team on providing some feedback in regards to treatment plans and crisis plan templates

Family Advisory Committee

  • The Family Advisors have been very engaged with recommendations for recruiting clients for research

  • It’s nice to hear that referring clients to research is becoming more common

  • Also happy to hear that the Thunder Bay team is looking into collaborative treatment plans, as we believe the benefit of NAVIGATE is coordination among the different care streams

  • Family Advisors participated in Family Education ECHO last month; great discussion about the family education component

  • Next steps: Brannon has a schedule for the Principal Investigators to come to the meetings and keep everyone connected

Recruitment Update

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