In attendance: Nandini, Alexia, Lillian, Jean, Nicole, Janet, George, Chelsi, Dielle, Nadia
Action Items: *** are time sensitive
Implementation
***Reach out to sites to set up dates for pre-training calls – Nadia/Chelsi
Site Readiness
***PSSP and ECHO to provide dates/times for interviews with sites as well as point person from each team who will be reaching out to the sites – Nadia/ Chelsi
*** SC members to send questions regarding site readiness (Lead-Derek Chechak/Alexia), fidelity (Lead- Mary Hanna/Janet) and ECHO (Lead-Christine Mitchell/Eva) interviews to team leads for each of these component cc’ing Chelsi/ Nadia/Dielle. Please send any questions that you would like added to the interviews in one email.
*** Overlap between elements of clinical and implementation readiness → Sarah and Alexia to connect, add Sarah to call with implementation specialist to discuss cross-over
***After above tasks are completed, introductory email to be sent to sites to coordinate Fidelity, PSSP, ECHO interviews → Dielle
IRT Handouts & Tip-Sheets
Handout and tip sheets for each IRT module → Sarah/Janaki/PSSP
What is the timeline for these handouts? Before or after pre-training? – Sarah
Manual Translation
Get a Word document of IRT module for modifications – Janaki
Administrative & Operational
***Durham has one major REB concern that needs to be addressed before the remaining responses and comments are sent out- the re-submission will go to full board review on Nov5th→ Dielle and SC (see attached response from Durham and comment highlighted in red that needs to be addressed)
Follow-up with legal for site contracts and send out early next week – Nadia
***Contract with Piper needs to be completed before pre-training calls – Janaki
Draft potential schedule of NAVIGATE support calls → different versions and outstanding items– Janaki/George
Consult model of blended NAVIGATE & ECHO sessions in the States – George to reach out to Susana
Establish ECHO call timeline – Sanjeev/Eva/Christine
Address Post-Launch Meeting Agenda Points
Minutes
Implementation
Site Readiness Assessment:
Janet and Mary Hanna taking the lead reaching out to sites about fidelity review
Excel spreadsheet is in the T-Drive → missing information from Sudbury and some values from other sites
Mary Hanna connected with sites for pre-fidelity conversations → sent doodle poll
PSSP site leads meet twice a week with sites → currently finalizing the landscape interview template
If any member of the steering committee has additional questions for site readiness reach out to the appropriate PSSP, ECHO or Fidelity point person
Fidelity, ECHO, & PSSP readiness assessments will be conducted separately but introductory email will be coordinated by Nadia/Chelsi
Mary Hanna → if Fidelity can’t get a single meeting time with sites they will conduct individual site meetings, already building a relationship in this area
Alexia → implementation specialist will need to gather site readiness information, there is overlap between clinical and implementation readiness
Meeting with PSSP, Sarah, Janaki to review site excel readiness document to review staffing mix
Pre-Training Calls
Modified training based on lessons learned NAVIGATE implementation at CAMH
Pre-training allows is focused on exposure to the content of NAVIGATE; in-person training focuses on delivery of NAVIGATE
Only site clinicians receive pre-training; all staff members receive in-person training
Pre-training call structure and content
1st call → led by George & Sarah → high level overview about NAVIGATE, addresses the benefits, connecting the dots with provincial standards and how the intervention operationalizes the standards
7 calls with NAVIGATE Trainer (Piper S. Meyer Kalos) about 7 core modules of IRT module
Need to have contract in-place with trainer before the calls can start
Proposed start date of November 12th or 19th, 2018
Sites will receive electronic documentation of NAVIGATE manual prior to pre-training calls
Susan Gingerich is the lead trainer who will delivery NAVIGATE in-person training on February 6-7-8, 2019.
In-person training will focus on the other components of NAVIGATE and guiding principles
Optional modules 8-14 will be explored during trainer follow-up calls over the course of the year
Piper Training Call Time Suggestions: Tuesday afternoons (1-2pm; 2-3pm; 3-4pm); Wednesday mornings (10-11am or 11-12pm); Wednesday at 4pm – Piper’s availability
Trainer Contracts
Janaki has previously made the contracts → Piper can sign the contracts as an independent contractor outside her role at her institution, resulting in a faster turnaround time
Aristotle has already signed the contract and we have received a validation from procurement
Readiness Monitoring Tool
Requires some knowledge of the intervention before using the survey
Option to perform the RMT in late February/early March before NAVIGATE is implemented at the sites and after the delivery of in-person training
Three components of the RMT: motivation, skills and general organizational support for implementing a new intervention
ECHO
Timeline for ECHO involvement in support calls?
Follow-Up NAVIGATE Calls
1 year of support calls from the NAVIGATE trainers, some of which are intervention specific
IRT calls → bi-weekly for the first 3 months; monthly for the remaining 9 months
SEE, Family & Prescriber calls → 1 x month for the first year
Director calls → structure and schedule needs to be determined
Need to include ECHO calls in the schedule → potential to integrate calls to not overwhelm the sites
All calls will be an hour and will use Zoom infrastructure
Will also have other monthly calls with sites about research, implementation progress, etc.
George Ideas:
ECHO and IRT could have alternating calls → need coordination between these teams
Integrate ECHO & NAVIGATE calls into 2 hour blocks per week
Need to minimize the number of calls per month for the sites
Someone in the US is developing a blended structure for NAVIGATE & ECHO calls → potential model
Director calls → Sarah is the point-person for these calls
Addresses implementation piece and structural/organizational issues
PSSP also have implementation working on this
Members of the PSSP and implementation teams could be added to the director calls
These calls also address site-specific information such as bridging local services with community partners
Jean has experience with the director manual and calls → the director is the point-person around treatment and research → a lead at each site
Clinician concerns would be reported to the director and discussed with CAMH during director calls
Manual Translation
Need to modify some of the content in the manual to speak to Canadian and youth language → this is a challenge because PDF documents can’t be edited
Janaki is reaching out to Piper about getting a Word version of the IRT manual
Janaki has tried to reach out to Piper about the IRT manual to get a word document verion → some hesitancy because of fear of changes to core content
Solution → send translated manual to NAVIGATE for review
When does this translation component need to be accomplished?
Compiling IRT tip sheet that distils content of the modules that have been helpful for the Slaight team as well as a condensed overview package for clinicians → when does this need to be ready?
Mood content → unclear if this is necessary beyond Slaight → do other sites see non-affective psychotic disorders?
Outcomes for Affective & Non-Affective Psychotic Disorders
Won’t be able to measure mood disorders at systems level because of ICES codes which don’t distinguish between psychotic and non-psychotic mood disorders → comparison group will be limited only to schizophrenia spectrum (codes 295 and 298). Will have to articulate that only a specific cluster is being examined at the system levels.
The intent is to deliver NAVIGATE to everyone with early psychosis
Patient outcomes will include affective and non-affective patients
Administrative and Operational:
Durham-Lakeridge: waiting for comments form a lawyer before sending REB back by end of this week
Almost have final approval from Sudbury
Call with North Bay REB on October 20th, 2018
Waiting for expedited approval from Niagara