Steering Committee - June 10 2020

ACTION ITEMS

· Identify 1-2 advisors who would be interested in collaborating on the new virtual care study – Lillian and Augustina

· Follow-up with Steering Committee members re: updates for Newsletter – Andrea

· Attend an Implementation Call with site leads to check-in re: ECHOs – Sanjeev/Jenny

· Utilize session 1 feedback and coordinate hub facilitator for next ECHO session – Abanti

AGENDA ITEMS: Administrative/REB/Contracts

SPOR Report

  • Thank you for your feedback on the SPOR report!

  • Currently in process of finalizing and will be submitted soon

  • Have not received a set deadline for submission, but we are on good track

Newsletter

  • The second edition of the newsletter will be released at the end of the month

  • Andrea has reached out for updates around the different objectives, will design and format all content

ECHO

  • Last session attendance: 24 spokes, 18 survey responses (75% response rate)

  • Received mixed feedback from sites about last week’s ECHO; some indicating they want more structured clinical focus

  • Is it possible that we have a cohort effect? Currently the survey feedback is anonymous so we cannot identify this.

Implementation Call with Site Leads

  • Sanjeev or Jenny can join one Implementation Call with sites to ensure everyone is on track.

  • Two of the new sites will not be on the Implementation call today (Jen and Anne-Marie) but follow-up has been planned

  • Implementation Call with site leads should address the value of the time spent collaborating and skill sharing on ECHOs and how sites structure their weeks

  • Originally, Durham had unrest among team and once they found momentum, clinicians asked lots of great questions which initiated the “super-user” clinician check-in idea to learn more.

  • For the first 3 sites, the ECHO team supported the onboarding of ECHO with feedback from PSSP.

Post-Training Calls

  • Sites have expressed that they enjoy the post-training calls, possibly because it is intervention specific. It is a more intimate conversation where they validated and have a chance to talk about their experiences using the material.

  • Trainer calls are still ongoing until July-August (IRT has 2 more, SEE and Family each have 1 more)

  • This may contribute to the feeling sites have of additional meetings, but as they are ending soon, we need to convey the benefit of the ECHO

  • They are not going to have the post-training calls anymore, ECHO will take the place of that for them.

  • ECHOs discuss specific skills and application of skills to patient care

Planning Upcoming ECHOs

  • The biweekly ECHOs have a modified format; no formal case presentations, more flexible now in anticipation of transition from post-training calls.

  • Abanti is compiling feedback from session 1 to formulate session 2 materials

Discuss Sites Interested in ECHO and NAVIGATE

  • ECHO is about meeting our deliverables and the model of care to our funders, so a newly interested site would need to be trained and go through what the other sites went through

  • We have an obligation to help a site start NAVIGATE

  • This is certainly achievable based on our experience with Thunder Bay, but we are at bandwidth based on current funding

  • Pre-COVID, we met with the ministry regarding longevity of NAVIGATE implementation.

  • We will need to re-engage with the ministry to create broader plan at provincial level for onboarding other sites as a true system-level model

  • Can still chat with interested sites and let them know a timeline for next possible phase.

  • The ECHO team is happy to support conversations with interested sites and we can always revisit this

COVID-19 CIHR Grant

  • Currently submitting grant application to evaluate virtual NAVIGATE delivery at CAMH for 1 year

  • The application is due on July 7th and will have an expedited turnaround time

  • Goal is to develop an adapted model of care that can be delivered during COVID-19 by building on the work of this group and Slaight

  • Slaight clinicians have had to transition rapidly to virtual model of NAVIGATE delivery

  • Primary objective: assess the Fidelity to the EPI model when NAV is delivered virtually

  • Goal: ensure delivering same high quality standard of care we have been trying to deliver in-person

  • We have the necessary elements in place to support evaluation and comparison of quality of care delivered in this virtual model.

  • Talked to Dr. Crawford about her expertise in tele-mental health and hope to draw on expertise of many people in this group

  • Primary evaluation we want to do with participation of some people in this group is assessing Fidelity to the EPI model when NAVIGATE is delivered virtually at CAMH.

  • We also want 1-2 people from the Youth and Family Advisory Committees to provide feedback throughout the project. They would be named on the grant and provide input on application.

  • Would also look at using routinely collected clinical measures (changes in symptoms and service engagement when NAVIGATE is delivered virtually using chart reviews).

  • Another benefit of the study would be to identify whether there are clients that the virtual model does not work well for, and adaptations that can be made to improve this

  • Eva has been working with clinical programs to look at how to evaluate outcomes in person vs. virtual. We will be in touch with Eva and Allison on this.

Virtual Fidelity UpdateDr. Janet Durbin

  • Due to COVID-19, Implementation Specialists cannot go to sites to conduct chart reviews

  • The Fidelity team has worked out a process whereby someone who is already based at the site will conduct the chart reviews

  • Don Addington developed chart review methodology in the U.S. study

  • He has modified the way data are extracted to minimize judgement and increase consistency

  • This solution means we don’t have a long gap between chart reviews and interviews, so assessors will have everything they need to make Fidelity ratings

  • Have received positive feedback from sites around this strategy

Advisory Committees

  • New FAC member joining next month, meeting on June 11th

  • Laura is working with the FAC to create about what NAVIGATE and this project mean to them

Patient Measures

  • Updating clinician research script to be consistent with participant brochure

  • Received 5 new referrals from Durham and 1 from NB; all have been contacted for research

  • Continuing to attend site clinical meetings to address and any research recruitment concerns

  • Completed trail testing with COVID Measures with RAs and will be incorporating into patient assessments

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