Steering Committee: May 29, 2019

In attendance: Chelsi, Jasmyn, Augustina, Dielle, Lillian, Dayna, Catherine, George, Aristotle, Eva, Paul, Sarah, Nikki, Janet


Action Items

SPOR CIHR Report

  • Review the report and email comments by Monday – Steering Committee

  • Email Nandini knowledge translation section of report to fill out by Monday – Chelsi/Nandini

Operational

  • Create agenda for all team tele-conference call for Wednesday June 3rd – Chelsi

  • Nandini attending the EPION Friday meeting? – Chelsi to reach out to Sarah

Onboarding

  • Discuss core competencies for training – Sarah and Latika

  • Add Peer Support to SURF – George

Niagara Logistics

  • Patient measures and outcome working group to collaborate with implementation committee regarding this – George/Alexia

  • Check TECC-Y’s process – Dielle

  • Connect with Krista – Sarah

  • Provide an estimate of average travel expenses for clients to the clinic – Sarah

  • Connect with Krista regarding room flexibility for assessments – Sarah

 

Minutes

SPOR CIHR report

  • Three parts to the submission: (1) annual report (2) work plan (3) budget

  • Deadline is the June 15th

  • Nandini to add her section regarding knowledge translation and SC to review/give comments by Monday

Niagara Logistics

Clinic space and booking

  • One shared high traffic room (3 different clinical services use)

  • Needs to be booked 1 month in advance

  • They may be able to tentatively book the room when they book the clinic appointment (about a month in advance), through a lot of the clinic room times will be blocked off (e.g. recurring series/meetings, etc.)

  • Theoretically we could book research appointments around clinic appointments, but it is unlikely that a client and their family would be able/willing to stay for that long

Research Logistics

  • 2-3 hour research appointments won’t be possible (need to split the baseline) – can’t book the room for more than 1-1.5 hours

  • Two new consults a week

  • Getting clients to the clinic will be difficult – the clinic pays for their travel expenses (some patients commute 60 mins each way)

  • Remote assessments – though there is some worry regarding their symptoms and delusions potentially to technology

  • Many clients don’t use email or will answer their phone – would get more clients through text

  • They see clients often in the evenings, and suggested that we would miss a lot of clients unless we can do evening appointments.

Communication and safety

  • If possible, they would appreciate if we could share the client’s assessments with the clinical team

  • They are happy with our proposed safety plan

  • Assessments in the clinic:

  • Get the clinicians’ cell phone numbers, and if there is a safety issue/consult we would text or call the primary clinician immediately for them to go to the room, then they would continue with their usual safety/risk protocols. We would also have back up numbers, which we would cycle through until we got a hold of someone.

  • We would also have a back-up clinician on-call on the CAMH side, just in case we can’t get a hold of someone at the Niagara clinic. The CAMH clinician may also do a safety assessment if the research analysts aren’t sure of the risk, before contacting the Niagara team (to reduce burden on the Niagara team).

  • We would follow up with a more detailed email to Krista and the primary clinician, to have a record.

  • Assessments outside of the clinic:

  • We would take down the immediate address of the client at the beginning of every call

  • If there is a safety issue/consult, we would have the on-call CAMH clinician do an assessment over video conference. If it is determined that the client needs support, we would call their emergency contact and/or 911, as appropriate. If the client disconnects the video call and we believe there to be sufficient risk, we will call 911.

  • In case of the above safety issue/risks, we would text or call the primary clinician to alert them (on their cell phone). We will also follow up with an email to the primary clinician and to Krista.

Other

  • We are enrolling new clients to the program, ideally after their first visit.

  • The first step is that they are referred to us by their clinician/physician – if the clinician/physician thinks they can’t do research right now, they aren’t referred.

  • The second step is that we go through an informed consent process, and we have to be confident they understand the nature of the research and the process in order to continue, otherwise they won’t be cleared to participate

  • If over the course of the study, we have concerns about their ability to give ongoing informed consent to participate, we may put them on hold until they are able to, or withdraw them from the study if necessary

Suggestions

  • Other - The first step should be going through the informed consent process and not for the clinician/physician to determine if they would be good for research or not.

  • The patient measures and outcome working group to collaborate with the implementation committee to figure out the logistics of this

  • Having regular communication with the clinical team about if they are enrolled in the study, opportunity to share assessments

  • Previously there were talks regarding having an EPI-SET RA at each of the sites, though that would not be financially feasible especially if they only have 2 consults a week

  • Remote assessments vs. in the clinic

  • Baseline should be done in the clinic so that the clinicians can introduce the RA to the patient and the follow ups could be remotely done.

  • Dielle to check with TECC-Y for their process

  • Potential REB amendment to increase travel compensation – will depend person to person. Jasmyn to get an estimate of how much the clinic spends on this

  • Sarah to connect Krista regarding room flexibility

Project Team Call (June 5th):

  • Standing committee updates from the leads (Site leads – giving updates as well)

  • Sending the Annual Report in

  • Scientific update:

  • Protocol paper – Jasmyn and Nikki

  • EPION update – submitted

  • Interactions between the committees for the SPOR mandate

  • The leads to present to the YAC/FAC

EPION Meeting – Friday

  • Josette and Sheila presenting from 11:30-11:45am this Friday

  • Is Nandini at this meeting? – Chelsi to reach out to Sarah

Onboarding

Training Modules

  • Sanjeev is exploring options for training modules.

  • They have audited and have a report on the NAV training with some recommendations for simulations/online modules

  • Hope to create some core competencies (Sarah and Latika are exploring these options)

Onboarding Call on Monday

  • Sarah, Dielle, Chelsi to have on-boarding call with WW on Monday

  • Creating onboarding document – collaborate with PSSP regarding this

  • Chelsi working on a way of documenting progress of modules at each site

Measuring Peer Support

  • Sarah has been in touch with Sean regarding a peer support tool

  • We need to clarify whether or not the peer work is about the specific work that they are doing or their specific involvement influences functioning (secure involvement).

  • It is hard to say which part is contributing to the work of the peer support aspect

  • Adapting the Personal Recovery Outcome Measure tool to say “because of the peer work I have been able to….” “since my time working with …, I am more hopeful about…”

  • That is a more subjective experience though

  • Waterloo-Wellington and Durham have peer support worker

  • Potentially we can compare the sites – using it as a variable instead – looking at someone who receives peer support and how that changes their outcomes compared to those who don’t have that service (engagement/disengagement experienced)

  • Sites might be using peer support in different ways - there might be a random process to that and who gets peer support

  • Potentially adding this item of peer support to the SURF

  • “In the last 6 months have you received any peer support?… how often?”

  • There shouldn’t be an issue with modifying the SURF further

  • Using it as a moderator potentially

ICES

  • Looking at peer support from the ICES level

  • Looking at the receipt of peer support on outcomes

Ministry

  • Why would some sites have peer support and not others

  • Lisa Dixon’s journal is already looking at the peer support about the personal perspectives of it, no need for us to add to that literature

ECHO Update

  • Finalizing the curriculum – Sarah to find presenters after finalization

  • 3 staff from the hub are going to the immersion training this week

  • Chelsi setting up another training with the rest of the hub members

  • Accreditation has been submitted


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