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Steering Committee: June 12, 2019

In Attendance: Jasmyn, Mary, Augustina, Lillian, Dielle, Dayna, George, Nandini, Sanjeev, Sarah, Janet, Aristotle, Paul, Nikki


Action Items

Committees

  • Forward questions from Life Skills the Family Advisory Committee suggested adding to the WHODAS – Lillian

  • Review and provide feedback – George

  • Pass on Lillian’s contact information to education services for e-learning review – Sarah

  • Send out the fidelity table/materials for Steering Committee to take a look at – Janet/Jasmyn

  • Service Measures and Outcomes Terms of Reference

  • Take out the names - Janet

  • Circulate to SC for approval – Jasmyn

  • Submit REB amendments early July once engagement piece is decided – Jasmyn/Dielle/Chelsi

Other interested LHINs

  • Create executive summary for the ministry - PSSP

  • Book a time to have a conversation with sites expressing interest – SC

  • Connect with Lisa and the structured psychotherapy working group about the online platform/routine data – SC

 

Minutes

CIHR Annual Report

  • The annual report is nearly finished, it will be sent out by the end of the week

  • WHODAS/Life Skills Tools from Family Advisory Committee

  • The Family Advisory Committee had a meeting on Friday

  • They supported capturing the family interpretation of youth functioning

  • The WHODAS complements what we are collecting from patients, and they supported it generally

  • They saw some questions in Life Skills that might have a better emphasis on mental health

  • E.g. are they taking their medication, are they behaving offensively, etc.

  • The question was raised: if we use the WHODAS, can we add some questions from Life Skills?

  • o Lillian will send the actual questions they suggested to be added

  • o What the WHODAS taps into is broader

  • o We would struggle with what to do with that data

  • o We will discuss and give feedback and engage again about this

Family Advisory Data Cleaning Question

  • Hugh is also participating in another project

  • He brought back: there was frustration when they talked about collecting data for a couple of years, but when they went to analyze the data, they had to invest time in cleaning it as opposed to getting to the research results

  • He wanted Lillian to raise to the group: to think about data collection up front, to bring up this point

  • Response: Part of the platform we use (REDCap) does give the ability to do regular data quality checks, and we do that routinely

  • We wouldn’t wait until the end of the study to look at the quality of the data

  • Issues would be addressed ASAP if they came up

Family Advisory Question about SEE position evaluation in research

  • This is an important role in wrap around care model, but often youth aren’t ready to consider employment when they start

  • There are concerns about how that will be portrayed in the research

  • I.e. as it not being effective vs. having the patients not ready for that stage yet

Family and Youth Advisory Engagement Measures

  • Family Advisory Committee also reviewed engagement questionnaires

  • Simone will come to next Family Advisory Committee, they will ask questions, etc.

  • They understand and support the importance of collecting this data

Family Manual e-learning

  • Sarah requested: would Family Advisory Committee be up to taking a look at the family manual that has been made into e-learning for families?

  • Education services is in the pilot stage of developing the e-learning

  • Lillian says yes

  • Sarah will pass on Lillian’s contact information to education services to go from there

Fidelity Update

  • Almost decided on a scale and process for rating the items

  • It took while to get to this point

  • Started aligning with EPION scale, then EPION ended up using two versions of the scale so there wasn’t consistency with aligning with Ontario

  • Decided to align as much as possible with Don’s tool (November version)

  • There ended up being a January version as well

  • Had consensus rating meetings with Don after two sites – there were other differences in how we were rating

  • With EPION there was a lot of adapting to context

  • The tool should be consistently used

  • The group documented all of the changes

  • Collected data at two sites but haven’t reported it back yet

  • 4 items we need SC input on – Ontario contextual differences, and need to decide how to rate the items

  • 3 are medication issues (schizophrenia spectrum vs. broader diagnoses), 1 related to whether partnerships should be acceptable to deliver a component of the intervention

  • Janet will send out the table/materials later for Steering Committee to take a look at

  • May need to go back and ask more questions of the sites as well to re-rate

Service Measures and Outcomes Terms of Reference

  • The Terms of Reference was approved by the working group

  • Only comment – lists names of members, wonder if should take them out

  • Will take out the names

  • Circulate to SC for approval (Jasmyn will re-attach)

Thank you to Nandini!

  • Her last day June 20.

  • Before she leaves, she will introduce to the new assistant manager of special projects in the KE portfolio, who will be working with Sarah and likely the EPI-SET project

PSSP Update

  • Al Cudmore is the PSSP implementation support for the Waterloo Wellington site

  • He is already in contact with Kim from the site

  • Mary/Dayna have an orientation set for tomorrow to orient him to the project and answer questions

  • He has been sent relevant resources as well

  • He works in the office with Sandy (who does Niagara support)

Sudbury site update

  • Aristotle had a call on Monday with one of the LHIN directors

  • She thinks that there should be more emphasis on quality of care and accountability

  • Has an FTE for Sudbury contingent on them joining the EPI-SET project

  • Next steps – get in touch with Sudbury director level (who is on board) who would then work to get the Sudbury team on board

  • Waiting to hear back for another call, LHIN person will also be on that call for a warm handoff

  • Training could happen simultaneously with Waterloo Wellington

  • REB is already in place

Thunder Bay and other LHINS (Central west, TC, MH)

  • Other sites are also expressing interest in EPI-SET/NAVIGATE

  • There is only funding to do research with sites that expressed interest initially

  • Need to have a phase two, which likely needs to be at least partially resourced by the ministry

  • We need to sort out what a scaled back version looks like

  • o Measure fidelity

  • o ICES data comparison

  • o Not patient level data

  • o Keep people with lived experience involved, but may not measure their engagement in the same way

  • PSSP team will do an executive summary for the ministry and get it back to us

  • Resourcing will be on supporting ongoing implementation and sustainability

  • We should book a general time to have a conversation with a few sites who are expressing interest

  • o Timeframe, context, etc.

  • We should connect with Lisa and the structured psychotherapy working group about the online platform for routine data

  • PSSP and ECHO - sustainability resources

  • o ECHO ministry reports – super hub collates data and does reports

  • o Each ECHO provides ministry reports if not part of super hub

  • o No accountability piece yet where funding is tied to it

  • Need to make sure the current sites also continue to have the resources they need

  • Is this the time to reconsider how EPION budget is used?

  • o Mandate is training and quality of care

  • o Could be a conversation to have

  • o Can come on heels of QI survey from fidelity (part of EPION workplan)

Patient Measures and Outcomes

  • Depending on level/change in risk, amendments may or may not go to full board review. We should submit whenever the amendment is ready to go.

  • We will wait for engagement piece to submit everything early July

  • Contract amendments need to be re-signed with the three current sites

  • Recruiting timelines

  • We are revising to recruit within 1st year of treatment, as opposed to only at the first visit

  • We will also revise the assessment schedule to align with treatment timelines, as opposed to study recruitment timelines

  • Safety and risk assessment questions have come up from the sites/logistical planning

  • This should be developed in consultation with the sites

  • If the clients are at the clinic, we will contact a clinician for them to follow their usual protocol

  • If the clients aren’t in the clinic during the assessments, this process will be worked out further in consultation with the sites


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