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G1 Rapid Fire:  Designing a Foundation of Quality for Mental Health - L. Kallstrom and C. Southey

G1 Rapid Fire: Designing a Foundation of Quality for Mental Health - L. Kallstrom and C. Southey






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  • Bi-partite committee between the government and BCMA to address full-service family practice incentives PSP: One of the three major initiatives of GPCS including Incentives; Divisions of Family Practice and the PSP Funded through the 2006 agreement between the government and BCMA Governed by GPSC We are not CME. PSP is about making permanent clinical and administrative changes in your practice. Small changes are tested and results are shared to help each other improve. Collaborative work is based on the concept of trying out small changes “next week” and then refining, testing again, and once you are ready, embedding the change into the practice as a new way of doing things. Small changes are tested on an ongoing basis to reap the benefits of small gains. Results are tested and tracked on an ongoing basis to see what works and what doesn’t. Physicians and MOAs are reimbursed for their time away from their practice; dedicated time to reflect on their practice
  • Burden of Child and Youth ADHD, Anxiety and Depression in BC. In addition we know that if we catch these conditions early on in life they are more amenable to treatment. By detecting and treating these conditions in children and youth we hope to improve QoL and prevent worsening symptoms down the line.
  • The aim of the module was…..the screening tools noted are the major tools we are using to detect and monitor Depression, Anxiety and ADHD in children and youth.
  • The main areas of focus in the module are…
  • Since October 2011 we have been in the train the trainer phase of this work, building capacity and testing ideas with our GP champions and who are going to head this work in communities. The train the trainer phase had participants in communities from around BC. The process included>>>>

G1 Rapid Fire:  Designing a Foundation of Quality for Mental Health - L. Kallstrom and C. Southey G1 Rapid Fire: Designing a Foundation of Quality for Mental Health - L. Kallstrom and C. Southey Presentation Transcript

  •   Primary Care Solutions for Child and Youth Mental Health: A Community-based Approach Liza Kallstrom - Practice Support Program, Content LeadChristina Southey - ImpactBC, Quality Improvement Advisor
  • Today Why Child and Youth Mental Health? What makes this module special? What have we seen so far? What’s next? 2
  • Have you heard about theP r a c t ic e S u p p o r t P rog ra m? 3
  • What is the Practice Support Program? Support full service physician practices Sponsored by the General Practice Services Committee (GPSC): BC Medical Association and the Ministry of Health Change management support to modernize medical practices in two areas: › Clinical redesign › Practice efficiency Topic areas include: Group Medical Visits, Adult Mental Health, Patient Self-Management Shared Care, Child and Youth Mental Health 4
  • Why Child and Youth Mental Health? Most mental health conditions onset before 25 80% are amenable to treatment We can change trajectory with primary care interventions 5
  • Why Child and Youth Mental Health (CYMH)? Estimated Prevalence % numbersAny anxiety disorder 6.5% 60,900ADHD 3.3% 30,900Conduct Disorder 3.3% 30,900Any depressive disorder 2.1% 19,700 6
  • Module AIM W ithin 6 - 8 months, we aim to improve child and youth mental health in participating practices as evidenced by improved scores on K A D S, SC A R E D and SN A P . 7
  • By focusing on… Identification, diagnosis and management Appropriate use of evidence-based treatments Appropriate application of standardized methods of measurement Awareness of community mental health resources available Family physician collaboration with community partners 8
  • What Makes this Module Special? Patients and their Families GPs PSP and MOAs Regional Support Team Ministry of School Children Counsellors and FamilyDevelopment Specialist - CYMH Physicians 9
  • Integration in Action 10
  • Whe re a re w e no w ? 11
  • Train the Trainer (TTT) Process TTT1 TTT2 Action Period Province-wide participation Opportunity to test and provide feedback on content/processes Full day sessions 12
  • What was achieved? 228 Children and youth screened 225 On a registry with anxiety, depression or ADHD 110 Treated with non-pharmacological interventions 42 Treated with protocol driven medications 13
  • What’s happening? 10 Teams working on processes between GPs and schools 6 Teams working on processes between GPs and specialists 7 Teams working on involving patients and family in care 7 Teams working on leveraging community/provincial supports 14
  • C o m m u n ic a t io n & C o lla b o r a t io n 15
  • Innovative Examples… In C r e s t o n they’re testing Mental Health primary care visits in the local high school In V e r n o n they’re testing phone consultation with the Specialist and GP around treatment and medication advice. In N a n a i m o they’re testing open call–in times for GPs during case review meetings at MCFD. A l l A c r o s s B C GPs and School Counsellors testing ways to screen children and youth, and share information. 16
  • How this has impacted team members… “…connectedness, reassurance that youth will have follow up by other team members – I feel less like kids will fall through the cracks” -School C ounselor 17
  • “... By bringing in the GP or the school, you bring in more comprehensive support” -GP
  • But best of all… 19
  • Next Steps Piloting in small cohorts Provincial roll-out starting in fall of 2012 (500 GPs funded) 20
  • Summary The potential impact of this work is BIG Integration is at work We are increasing capacity in primary care Practitioners enjoy this work Real results can be seen Spread Ahead! 21
  • F o r m o r e in f o r m a t io n Practice Support Program 115 - 1665 West Broadway Vancouver, BC V6J 5A4 Tel: 604 638-2873 www.pspbc.ca 22