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Steering Committee: January 30, 2019

In Attendance: Chelsi, Jasmyn, Dielle, Nandini, Janet, Sarah, George, Aristotle, Nicole, Eva, Lillian

Action Items


1. EPI-SET Key messages

  • Edit document [1-pager] – Chelsi/Nandini

  • Send to Steering Committee – Chelsi

2. Investigate NAVIGATE Fidelity assessment items

  • Contact Don Addington regarding assessment of fidelity in cases with dose reduction vs. discontinuation vs. lowest effective dose (EPI-NET?) – Janet

3. Connect Steve Hawley to Janet regarding Readiness Survey via REDCap– Chelsi (done)

4. Follow up with Durham REB and North Bay/Niagara contract– Dielle


  • Start meetings, have a chair, have terms of reference, communicate with the steering committee, etc. – All Committees

  • Connect Simone with Augustina/Nadia to discuss Youth Advisory Committee – Chelsi

  • Provide Family Advisory Committee with research on NAVIGATE/the stats on outcomes vs the rest of the province – Aristotle to forward to Chelsi

  • Send calendar invite to implementation outcome committee to Chelsi – Janet

In-Person Training

  • Connect with North Bay community family partnership designate regarding in-person training – Sarah

  • Speaking about ECHO sessions – Chelsi - Send invite to Eva (Friday morning/working lunch) - Send invite to Sanjeev (Wednesday working lunch) - Send invite to Christine (Thurs/Fri director meeting) - Add Family Advisory Committee session to Thursday morning agenda – Chelsi - Send PSSP invitation to in-person training (Order of priority is 1. Wednesday 2. Thursday – IRT training/general, 3. Friday – general) including Alexia/Nandini – Chelsi

ECHO Planning Sessions

  • Email Sarah/Dr. Foussias first couple planning invitations – Chelsi

  • Confirm 3 clinicians to be in planning sessions – Sarah

  • Send planning dates to physicians – Chelsi



EPI-SET 1 Pager

1. Sent around just before meeting by Dielle

2. Nandini sent a 1 pager about the NAVIGATE model for circulation to the different sites, as it was a need identified by the different sites.

3. It could also be for EPION (Sarah) for sites to be able to provide when people are asking what NAVIGATE is, for their administration, etc.

4. Revisions:

  • Last page: patient outcomes will be assessed through research assessments, not ICES

  • Have a sentence about each of four outcomes on the 1 pager – each have a bullet point (fidelity, system level outcomes, patient outcomes, etc.)

  • Fold in cost-effectiveness to system level outcomes

  • Besides project lead, that role “provides scientific leadership and content expertise”

  • Stakeholders – add the Ministry in some way

  • “Community healthcare outcomes” (change from “health outcomes”)

  • Why use NAVIGATE section, first bullet – do we know that they do reduce emergency visits, and that everything is correct? (Info is probably from Kelly’s paper.) We should make sure each point is totally accurate, and double check them. Also we should structurally match to the 4 outcomes, and each bullet itself has to be accurate and reflect evidence for why we’re doing what we’re doing.

  • We need to make sure we acknowledge existing EPI programs, and don’t undermine them. We should frame EPION and Ontario EPI services as the next step/uptake group and we should be empowering and accurate in terms of what we hope for

  • Chelsi – edit document, sent to Nandini, then she will go through it. After Nandini incorporates and agrees with changes, she will then send it out and go through line by line with the steering committee before approval

  • Add a link to the ECHO website for front-line staff

In-Person Training

  • Working lunch is to help let front line staff to know they are part of something big and exciting. I.e. what’s being measured, where they will get help from, meaning for the future, etc.

  • We want to maximize use of the schedule to make sure that front line staff are motivated by the work. We will have PSSP workers there at the training, ECHO people can be there to have in-person discussion around planning of ECHO, this way everybody will know what people are doing.

  • We will have a link to the ECHO website as well, so that staff can understand the model, understand the ECHOs going on in Ontario right now, and situate the research project in a broader service provision.

  • ECHO and PSSP leads should also be involved in the director training at the end of each day of in-person training. They should also be invited to key bits across the way, i.e. ask them to come to a key hour here and there. This will help put faces to names, communicate, key info, facilitate interpersonal bonding, etc.

  • ECHO: Eva can come on Friday morning/working lunch (Sanjeev has mandatory workplace violence training some days of in-person training, and is facilitating an ECHO meeting on Friday). Sanjeev can do the working lunch on Wednesday. Christine can do beyond that – e.g. she may be able to join at the director meeting(s). Chelsi will send out specific Outlook calendar invites.

  • We will plan to use lunch on Friday as working lunch. Wednesday will be an overview, Friday will be an opportunity for Q&A and conversation with PSSP and ECHO, and physicians will be there. Friday will be an opportunity for people to understand how things work from a process point of view (they will have the content, so can focus on how we will help them get where they need to be, key processes, etc.)

  • In terms of how Friday can be used most effectively, we will leave it to Eva/Sanjeev/Alexia . E.g. in real world terms, addressing to front line providers what is the role/timeline/how to be flexible – what are the nuts and bolts of what this means for you (the front line provider) and your site now that you’ve been exposed to the content.

  • Sarah has a one pager that’s been used to reach out to her clinicians. Eva suggested a one pager for sites, and she will help frame the discussion around the value impact, value statement of ECHO, what they can expect from participating in ECHO, etc. We don’t need the one pager for in-person training, there is too much already to be learned.

  • Not going to record videos, as there’s already too much going on – for the sustainability modules.

  • Lillian from the Family Advisory Committee is going to the morning break on Thursday to meet with the family workers, so they should be told what the meeting is about in advance. Can be added to the Outlook invite.

  • Dielle approved the Outlook invite today, so that will be sent out. The Agenda is on the web portal.

  • A question was brought up of whether PSSP can attend specific module sessions. Consensus was that if it’s just a few, it won’t be obtrusive, and it will likely be useful for getting a sense of the staff they’re going to be working with – how hard is it going to be, who is going to be the leader, who is going to have a hard time, etc. which could inform what they do afterwards. Friday IRT training likely won’t be useful for implementation people, as it is more about cognitive restructuring skills. Order of priority/usefulness is 1. Wednesday, 2. Thursday, 3. Friday. Any general group sessions should also be prioritized. However, if they’re around, the more they attend the more they are going to know what is in store for the next few months. People who can’t travel should attend via Zoom, as their attendance is important for their ability to be effective on the ground, manage anxiety around change, etc. This and the agenda can be sent out to PSSP people by Chelsi.

  • North Bay outsourced partnership people – can their designate from the community come to the in-person training? Can we support in theory/financially? We should see if they can come/ if their agency will free them up to do this, and then tackle these questions. Find out ASAP – Sarah

  • Lillian needs the details of where she is going – Dielle and Chelsi need to send out / sort out room 5221/5227 – Chelsi will send out room numbers

ECHO Planning Sessions

  • ECHO planning sessions start beginning of Feb, meetings are set. These meetings don’t all need to be decided in the bigger group (Steering Committee), can bring specifics to the planning meetings

  • Suggested to float a couple of other potential meeting times, as some individuals can’t make the first few meetings – however this would be based on prioritization, and if prioritizing Sanjeev, then current dates were based on his schedule. Sarah can possibly do Wednesday meetings, but likely not Friday mornings.

  • For tapering off planning meeting attendance, there is a front loading of work, so once there is clarity certain deliverables can be followed-up on via email. We should prioritize Sanjeev being there to build curriculum.

  • Chelsi will send an email with meeting invitations (for the first three meetings) to Sarah for the planning sessions (possibly the 8th and 15th and another?)

  • Christine sent an example project plan, which the group can go over at the first planning session (probably on the 8th). E.g. deadlines, milestones, an if people aren’t around, can identify how to get and integrate feedback

Implementation Committee

  • All committees need to start going live, have a chair, have terms of reference, communicate with the steering committee, etc. Some features will be common across committees, some will be unique. Implementation Committee needs to be formalized ASAP (e.g. who is chair, co-chair?).

  • From the ECHO group, one person should join implementation committee, it is important to understand the implementation background, and some ECHO specific implementation things. Possibly Christine can make the meeting.

  • Research Analysts/Research Coordinators will fan out and be available for each of those meeting times, for the 4+ key groups to provide support, take minutes, etc.

  • Outcome meetings should be set up, put in a standing meeting every 3 months so it is at least formed

  • Implementation outcomes meeting on Feb 8. Melanie Barwick and Suzanne Zerger should join, Janet is chair, a Research Analyst or Coordinator will join for support. We can see at the 1st meeting if anyone not on the list should be present.

  • George had a call yesterday with NAVIGATE trainers regarding the fidelity assessment. We should send them the version of the tools we are using. NAVIGATE and fidelity from our perspective is different from Don Addington’s tools – the recommendations aren’t about dose reduction or discontinuation, but is about the lowest effective dose. Because of this, fidelity may look like it is never achieved, but in this case it can’t ever be achieved if NAVIGATE is implemented properly. We have to figure out the tool, and since they use it, they may have other thoughts or concerns. With fidelity assessments being done, there should be enough information in the notes of the tools to be able to rate items differently if necessary. Don is on a bunch of grants for a similar project competition in the US (possible EPI-NET?), and they may have a similar issue, so we should contact him to see if he has addressed this issue.

  • PSSP is starting a readiness survey via REDCap, so Chelsi should connect with Steve about this


  • Simone wants to know how she can contribute to the youth engagement committees, and if she should attend a meeting to introduce herself. Consensus was her job is to measure engagement, know what scales we are using, who we are administering them to, etc. to do with the 2 scales we are using to measure youth/family engagement (which we need to move forward with). She was also wondering who was running the core team meetings to connect with them and provide guidance (Nadia and Augustina). Simone can call into the next meeting with Nadia/Augustina.

  • Statistics on outcomes and rest of project to be sent to Hugh: send grant, send RAISE paper, send Aristotle a reminder for more papers (Chelsi) that have original outcomes, engagement, service delivery and utilization, quality of life paper, etc.

  • Dielle: 2 emails sent to Durham, no updates so far from them, will wait a day then email again

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