In attendance: Aristotle, Lillian, Sanjeev, Eva, Sarah, George, Alexia, Janet, Chelsi, Dielle, Nadia
Action Items:
Follow-up items from the Launch:
1. Steering Committee Members
Contact Patrick Mitchell regarding policy member as representative in steering committee – Aristotle
Invite Augustina to be potential lead youth representative on the Steering Committee – Dielle
2. Governance
Invite Sara Traore to Youth Advisory Committee – Dielle
Follow-up with Family Group members – Sarah
Follow-up with Caroline about potential SCEIS family member - Dielle
Formulate operations sub-committees/working groups for each aim/outcome. Assign members to committees. Send draft of committees and members for next week - Chelsi/Dielle
3. Measures
Follow-up with Eddy Nason regarding goal attainment as a quality of life measure – George
Measure DUP with SCID → clarify with Jean if this is based on onset of symptoms or onset of diagnosis? – George
Use ADDIS for alcohol and drug use scale (cross-reference with PSSX study) → to be added as REB amendments after initial approval
4. Find out more about evidence-network advisement for SPOR from Vasanthi – Dielle/Aristotle
Operational
1. Steering Committee members to respond to questions form Lakeridge REB by Thursday Afternoon (Nov. 1st) – Dielle/SC
2. Assign questions from Niagara REB response to SC members on Monday- Dielle
3. Send contracts to all sites on Monday (except Durham) – Dielle
4. Meeting around site readiness assessment and implementation landscape – Alexia, George, & Sarah
Identify site members for pre-training calls, in-person training break-out sessions and post-training calls
Training
Email sites informing that anyone providing case management should be on pre-training calls – Chelsi (done)
Send pre-training call options to implementation specialists – Chelsi
Send pre-training confirmed time by Friday to Janaki (to inform Piper) – Chelsi
Get feedback from Piper about materials for pre-training calls (full modules or clinician guide and condensed handout) – Sarah/Janaki
Look into community resources for different NAVIGATE roles – PSSP
Decide if in-person training session will be recorded – Sarah/George
Contact education specialist to formulate NAVIGATE sustainability training/as potential auditors for in-person training – Sanjeev
Meeting Minutes:
Follow-Up on Main Points from Launch:
1. Reach out to Patrick Mitchell to find suitable delegate who can regularly attend SC meetings for policy representation (Catherine Ford)
2. We will use the ADDIS to measure alcohol and drug use as part of patient assessments → this will overlap with Miner’s Lamp study at Slaight and can be incorporated into the protocol as a future amendment after initial approval
3. Measuring duration of untreated psychosis (DPU)
RAISE study used the SCID
Unclear if this is based on onset of symptoms or onset of diagnosis → follow-up with Jean
4. Governance Structure
Develop operations sub-committees/working groups for measurement of each aim and outcome (e.g., ICES, patient-level, implementation and engagement) instead of a research/administrative operations committee. PIs and Co-Is would represent each of the outcomes.
Youth/Family Advisory Committees will address patient/family engagement outcomes
Steering Committee represents the intersection of various committees and executes high level operations
Site managers/leads should be involved in the implementation committees
ECHO will also interact with site managers/leads for organizational readiness
Clinical needs assessment will help build the curriculum within ECHO
Clinical pieces around needs assessment to build the curriculum within ECHO
5. Aristotle to follow-up with Vasanthi at OSSU meeting in 4 weeks to explore evidence-network advisements for SPOR
Recruitment of Youth/Family Members
2 potential candidates → both referrals form the TECC-Y study → 1 no longer has the time/travel barrier → teleconference could be an option
We need someone with lived experience and from central hospital → Sarah Traore is an option
Karleigh has identified three potential candidates → one responded to the NAVIGATE flyer, but has issues with commitment. She will call national advisory council to look for other candidates.
Augustina to be invited to Steering Committee as Youth Committee Lead Representative
Caroline → family member from SCEIS might be interested in joining
Need to populate committees with patients/family members with lived experiences from the sites. Other Sites: 4 Potential from Sudbury; 1 Potential from North Bay
REB Updates:
North Bay REB Call on Oct. 30 2018 → they did not have the full protocol during the discussion. We are waiting to hear back about their written questions.
Lakeridge REB: Additional responses from Lakeridge were received this morning → we need get our responses by mid-Friday to submit our responses for November 5th deadline. If we miss this deadline, we will have to wait another month to submit to their REB.
Received comments from Niagara site clinicians
Consent forms do not need to be equivalent across sites → focus should be on lay language
Site Readiness & Pre-Training:
Alexia has updated Implementation landscape document → look through site readiness excel sheet with Sarah and George to determine how breakdown of interventions will work for each site.
PSSP might need to look into community resources for different NAVIGATE roles
Some clinicians might have to do half IRT and half family components, others doing full IRT to maximize efficiency
Advanced practice clinician from sites should be on pre-training calls. Anyone providing case management (not those solely doing family work) should be part of pre-training calls
We are moving forward with pre-training regardless of REB approval → performed outside of research activities
Calls will begin the week of November 19th with Sarah and George
IRT modules to be sent out weekly → need to determine if they receive full module or condensed handouts
Training & Post-Training:
Sites don’t have enough staff to accommodate all NAVIGATE roles
Alexia and Sarah meet to determine who will be assigned to NAVIGATE components at each site
Decide if we can record the entire in-person training session → have not asked NAVIGATE trainers about this
Received responses that videotaping the sessions is not appropriate for adult learning → how can we support training → role playing and immersive exercises would be an option
Sanjeev → NAVIGATE training is not developed to train new staff after turnover → sustainability issue. They currently currently send new staff to a full 2.5 day training at another site, no virtual module. ECHO is similar, but trying to train regional staff – “train the trainer model”
We could apply train the trainer approach to NAVIGATE as they do not support this as much
Not sustainable for us to rely on US trainers only
NAVIGATE competent vs. NAVIGATE brand → need to train people on navigate competencies, move away from NAVIGATE proper, our training would be based on the model
How to make 2.5 day training accessible after the actual training
Eva – build into core competency online training
ECHO would take over on-going training to maintain level of knowledge
ECHO – didactic session + case based learning to solidify the learning
Create foundation learning session and immersive experiences based on in-person 2.5 day training (edit video recording)
Content is not conducive to purely remote learning → will need continuous feedback loops for individuals in their respective roles (Step Care model for education)
Also applies to Slaight Centre training – consider a regular foundational training session every 6 months → single training session for CAMH and site staff (similar to Temerity brain stimulation annual session) with ECHO involvement
Find out core competencies from the 2.5 day training
Sanjeev – education consultants could audit the 2.5 day training to determine how to build the appropriate education model
Additional Minutes from October 24, 2018
ALL TEAM MEMBERS – if you have any questions you would like to add to site readiness assessments (e.g., CBT training), forward all of your questions in one email to the respective leads at PSSP, ECHO & Fidelity so they can be incorporated into the interview guides
Fidelity – send to Mary Hanna (Janet)
PSSP – send to Derek (Alexia)
ECHO – send to Christine Mitchell or Eva
PSSP TO BE ADDED TO DIRECTOR CALLS because of overall
INTRODUCTORY EMAIL - Send out email introducing all sites to point persons at Fidelity, PSSP, ECHO for their respective readiness assessments and to provide pre-training call options from Janaki/Piper.
RMT – after in-person training ?
Timeline for all support Calls
Post-Training
1. Post training call map (visual) not sure if we need a visual as well as a chart (this will include trainer calls and other echo capacity building calls with us and the implementation team)– Sarah
2. Establish call ins for all sites (ie. Tuesday at 10am) –are these support calls? -- Sarah
Determine if additional time slots are needed for ECHO
3. For IRT non-trainer consultation calls (post training) – what is the framework of these for ongoing capacity building – module specific with patient examples? – these need to be created with CAMH clinician experts
4. Structure, frequency of calls – trainer and non-trainer/peer-to-peer learning/echo
Main Points from Launch:
1. Policy decision-maker regularly on Steering committee
2. Connect with Andrea Tricco/Sharon Straus – Evidence-Network advisement for SPOR – knowledge translation support provided by CIHR
3. Consider including an addiction scale because of high rates of drug-induced psychosis at some sites - incorporate as patient-outcome measure and make necessary amendments
4. Eddy Nason suggested looking at goal attainment as a quality of life measure
5. Look at how to measure the duration of untreated psychosis (DUP) - not currently addressed by the protocol
6. Differentiate ECHO and PSSP involvement in operations and implementation
7. Need to identify one leader from each site to be part of Implementation Committee (look for local champions)
8. Sara Traore - could join Steering Committee as a representative
9. Set up central training process for youth/service user and family advisory committee.
10. Diana suggested an operations subcommittee focused on measurement of outcomes
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