Conscious Instruction: Awareness, Restoration & Growth in Knowledge Transfer(FMI email CECE@UNE.EDU)
Global Forum on Innovation in Health Professions Education
The National Academy of Sciences, Engineering, and Medicine
To view the case study: https://youtu.be/mVjii51ODzk
Shelley Cohen Konrad, Ph.D., L.C.S.W., F.N.A.P.
Director, School of Social Work Director, Center for Excellence in Collaborative Education Professor, School of Social Work
Karen T. Pardue, Ph.D., M.S., RN, CNE, ANEF
Dean, Westbrook College of Health Professions Professor, School of Nursing and Population Health Interim Director, Nutrition
Chat Moderator
Kris Hall, MFA
Program Manager, Center for Excellence in Collaborative Education
August 2020
This presentation addresses Step 3: "Train New Recruits & Current Faculty to be Effective Educators"
This presentation, based on a University of Florida course on Fixing Patient Responsibility explains the importance of teamwork in healthcare, esp. with respect to saving patients' lives.
A Nursing Leadership Guide: Communication, Teamwork, Mutual Support, Conflict...Ahmad Amirdash
This presentation is a short version that briefly explains Effective Communication for error reduction in healthcare. It utilizes proven tools such as TeamSTEPPS training, Conflict Resolution, Patient Safety, healthcare education, Comprehensive Unit-based Safety Program (CUSP), NSPG, AIDET training, Mutual support, and Quality Assurance.
Please note that you're welcome to use any slides as long as you reference my post when you do so to maintain the integrity of authorship
If interested in detailed answers, please email: aamirdash@yahoo.com
Thanks, Ahmad Amirdash.
Stakeholder Engagement in Implementation Research: VA Women's Health ResearchUCLA CTSI
June 7, 2017
Alison B. Hamilton, PhD, MPH
VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy
UCLA Department of Psychiatry & Biobehavioral Sciences
A presentation of the Southern California Regional Dissemination, Implementation and Improvement Science Webinar Series.
Provided by the UCLA CTSI
Advancing Team-Based Care: Building Your Primary Care Team to Transform Your ...CHC Connecticut
Advancing Team-Based Care: Building Your Primary Care Team to Transform Your Practice
Presented 2/18/2016 as part of the CHC Primary Care Workforce Development National Cooperative Agreement
Conscious Instruction: Awareness, Restoration & Growth in Knowledge Transfer(FMI email CECE@UNE.EDU)
Global Forum on Innovation in Health Professions Education
The National Academy of Sciences, Engineering, and Medicine
To view the case study: https://youtu.be/mVjii51ODzk
Shelley Cohen Konrad, Ph.D., L.C.S.W., F.N.A.P.
Director, School of Social Work Director, Center for Excellence in Collaborative Education Professor, School of Social Work
Karen T. Pardue, Ph.D., M.S., RN, CNE, ANEF
Dean, Westbrook College of Health Professions Professor, School of Nursing and Population Health Interim Director, Nutrition
Chat Moderator
Kris Hall, MFA
Program Manager, Center for Excellence in Collaborative Education
August 2020
This presentation addresses Step 3: "Train New Recruits & Current Faculty to be Effective Educators"
This presentation, based on a University of Florida course on Fixing Patient Responsibility explains the importance of teamwork in healthcare, esp. with respect to saving patients' lives.
A Nursing Leadership Guide: Communication, Teamwork, Mutual Support, Conflict...Ahmad Amirdash
This presentation is a short version that briefly explains Effective Communication for error reduction in healthcare. It utilizes proven tools such as TeamSTEPPS training, Conflict Resolution, Patient Safety, healthcare education, Comprehensive Unit-based Safety Program (CUSP), NSPG, AIDET training, Mutual support, and Quality Assurance.
Please note that you're welcome to use any slides as long as you reference my post when you do so to maintain the integrity of authorship
If interested in detailed answers, please email: aamirdash@yahoo.com
Thanks, Ahmad Amirdash.
Stakeholder Engagement in Implementation Research: VA Women's Health ResearchUCLA CTSI
June 7, 2017
Alison B. Hamilton, PhD, MPH
VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy
UCLA Department of Psychiatry & Biobehavioral Sciences
A presentation of the Southern California Regional Dissemination, Implementation and Improvement Science Webinar Series.
Provided by the UCLA CTSI
Advancing Team-Based Care: Building Your Primary Care Team to Transform Your ...CHC Connecticut
Advancing Team-Based Care: Building Your Primary Care Team to Transform Your Practice
Presented 2/18/2016 as part of the CHC Primary Care Workforce Development National Cooperative Agreement
There are many examples of evidence-informed decision making (EIDM) among public health professionals and organizations in Canada. However, there are limited mechanisms in place to facilitate the sharing of these stories within the public health community. The National Collaborating Centre for Methods and Tools (NCCMT) seeks to address this gap with an interactive, peer-led webinar series featuring a collection of EIDM success stories in public health.
These success stories will illustrate what EIDM in public health practice, programs and policy looks like across the country.
Join us to engage with public health practitioners across Canada as they share their success stories of using or implementing EIDM in the real world. Learn about the strategies and tools used by presenters to improve the use of evidence.
Featuring:
Knowledge broker training for evidence-informed decision making: Building capacity in public health
Lori Greco and Dr. Megan Ward, Region of Peel Public Health
Region of Peel Public Health has identified evidence-informed decision making as a strategic priority, termed End-to-End Public Health Practice. Learn more about how this health unit is building internal capacity for knowledge brokering and evidence-informed decision making.
Making evidence-informed decisions about the Alberta Public Health well-child visit: The art and the science
Farah Bandali and Maureen Devolin, Alberta Health Services
In Alberta, there was decreasing time available for non-immunization well-child clinic visit activities and these activities varied at clinics across the province. Learn more about how these authors used evidence-informed decision making to decide on which routine activities to include in non-immunization well-child clinic activities.
Clinical Academic role in leadership excellenceNHS England
CNO Summit 2017, Day 1, 4.00pm
Professor Debbie Carrick-Sen, University of Birmingham, Heart of England NHS Foundation Trust, Florence Nightingale Foundation
If you want to learn more about how and why Saskatchewan is using Lean in health care, join us for this introductory session. During the Quality Summit, you will hear about various Lean tools, concepts and principles, and this session will serve as a quick primer for you, covering some “lean essentials” to enhance your Summit experience!
Getting an evidence based journal club into practice in a medium secure foren...Clare Payne
A Nurse Therapist and Outreach Librarian talk about their joint venture in setting up an evidence based journal club in a medium secure forensic hospital with the aim of leading to practice change. They discuss the evidence based principles that the club applied in practice, what worked well, and what didn't, the barriers they faced, the topics that arose in discussion, the resulting attitudinal and behavioural changes and practical outcomes to date. See notes for further detail.
Chief Allied Health Professions Officer’s Conference 2016
Workshop 3: Integrated Care – Chair Lindsey Hughes
iCares – population based delivery of care. Ruth Williams, Clinical Directorate Lead, Community and Therapies Clinical Group. Sandwell and West Birmingham Hospitals NHS Trust.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Oct 25 CAPHC Concurrent Symposium - Mental Health - Dr. Sharon Clark and Dr. Kathleen Pajer
1. The Choice and Partnership
Approach (CAPA):
Improving the Delivery of Mental
Health Care
Sharon Clark, Ph.D.
Registered Psychologist
Advanced Practice Leader:
CAPA
Kathleen Pajer, M.D., M.P.H.
Chief of Psychiatry,
Children’s Hospital of Eastern
Ontario (CHEO)
Professor of Psychiatry
University of Ottawa FOM
2. Collaborators
• Debbie Emberly, Ph.D., IWK
• Susan McWilliam, Ph.D.,
IWK
• Emily DeLong, B.S., IWK
• Alexa Bagnell, M.D.,
F.R.C.P.C.
• Barb Casey, M.B.A., IWK
• William Gardner, Ph.D.,
CHEO RI
• Dave Murphy, CHEO
• Marjorie Robb, M.D., CHEO
• Karen Tataryn, M.S.W.,
CHEO
• Laura MacLaurin, M.S.W. ,
The Royal
• Christine Slepanki,
M.B.A.,The Royal
• Gail Beck, M.D., The Royal
• Dr. Judy Makinen, Ph.D., C.
Psych, The Royal
• Rebekah Ranger, BSoc.Sc., BA,
The Royal
3. Doing the right thing, at the
right time, with the right
people.
4. Overview
• What is CAPA?
• How is CAPA different from other service
delivery systems?
• How does CAPA work?
• CAPA at three Canadian sites.
• Lessons learned.
• Questions/Discussion.
6. • “You do not have to have a waiting list.
It can be eliminated. We need to stop
talking about assessment and
treatment—things we do to people—
and talk instead about partnership and
collaboration.”
Dr. Ann York, Psychiatrist, CAPA Developer
7. • CAPA is innovative method to deliver Child and
Adolescent Mental Health Services.
• It improves patient flow and quality of care.
• Widely used across the UK, New Zealand,
Australia.
• CAPA makes child and adolescent mental health
services:
– user-friendly
– client/family focused
– accessible
– safe
– effective.
11. Fundamental change in philosophy of
clinical care.
Challenges all assumptions and asks the
“system” hard questions:
• What is the role of the family in care?
• What is the role of the clinician/physician in
care?
• What is our “core business”?
• What is value-added?
13. Shared decision making.
A consultative process where a clinician and client
jointly participate in making a health decision, having
discussed the options and their benefits and harms, and
having considered the patient’s values, preferences and
circumstances.
Involves the professional and the service user bringing
together their individual sources of expertise
14. Shift in responsibility.
Family bus ride has already
started. • The bus ride doesn’t start
start at MH care facility.
• The bus ride destination
is not the MH care facility.
• So, how do we get on the
bus with family?
15. Value-added care.
• Value is anything that improves
health, well-being or care
experience of patient/family.
• Value is defined by patient or
family.
• We identify the ‘value stream’ or
key set of actions required to
deliver value.
• The trick is to maximize actions
that add value and eliminate
waste.
16. Importance of letting go.
“CAPA is all about empowering people and
helping them access their own resources –
and those in their communities – to move
their lives forward. Part of this is not to
assume they need services….” CAPA Manual, 2013, p.
81
“Release people back into the wild”
17. Mechanics: CAPA uses quantitative
approach to service delivery.
• Demand and Capacity Theory
• Queue Theory
• Lean Principles
18. Capacity and resources.
• A key lever for improving patient flow.
• How do we measure capacity?
– What is the capacity of a 20 seat restaurant?
– A 16 bed ward?
• Capacity is a RATE
– Customers/hour
– Patients/day
• We can view a 16 bed ward as a queuing system with 16
servers
– What is the capacity of a bed?
• A delivery system comprises resources with capacities.
– Resources and capacity are not interchangeable; one is a
function of the other
– Capacity may fluctuate
Puterman, Martin, 2012, BHAC 510 Coursework
19. Demand and capacity.
• Too much capacity or too many resources =
idleness
• Not enough capacity = waits
• Resource manager must trade these off taking into
account system objectives and available resources
• Should we set capacity equal to demand?
– This is called a balanced system
– It works perfectly when there is no variation in the
system
– It works terribly when there is variation! Why?
• Once behind, you never can catch up.
– Queuing theory quantifies these tradeoffs in terms of
performance measures.
Puterman, Martin, 2012, BHAC 510 Coursework
20. Queuing models.
• (Mathematical) queuing models help set
capacity (or determine the number of
resources needed) to meet:
– Service level targets
– Average wait time targets
– Average queue length targets
• Queuing models provide more precise
alternative to simulation
• They provide insights into how to plan,
operate and manage a system
Puterman, Martin, 2012, BHAC 510 Coursework
21. Push-Pull: the milkman.
• Push – the milkman delivers every day
• The delivery rate come from the milkman
• Pull – the family puts out a bottle when they need
milk
• The rate comes from the family across continuum ofSlide taken from
22. CAPA: Putting it all together.
• Demand
– Each referral is a request for a clinical service;
demand is the number of clinical hours needed
• Capacity
– Skills bank and resources required to deliver those
skills
– Skill bank built with targeted recruitment and clinician
education
– Capacity is not number of clinical staff, but number of
clinical hours available to meet demand
• Queue estimates used to create job planning.
• Lean principles to map out efficient care with
least waste.
24. Slide taken from CAPA.uk.co
11 Key Components
CAPA Key Component Aim Why?
1. Leadership To drive and sustain Change management
2. Language
Active, understandable, non
judgmental
Engages clients
3. Handle demand Transparent and agreed Flow, transitions, joint working
4. Choice framework Shared decision making
Adds value, reduces waste, reduces
drop outs
5. Full booking
Smoothes flow, improves
engagement
Client has activities ‘pulled’ towards
them as they need
6. Selection by skill
Matching skills to need
Increase effectiveness of help
7. Core and advanced skills Evidence informed practice Effectiveness, workforce development
8. Job planning Defines and deploys capacity
Flow, monitoring, flexing,
commissioning
9. Goal setting and outcomes Regular outcome monitoring
Effectiveness and satisfaction, reduces
drop outs and drift
10. Peer group supervision
Learning, governance, reducing
variation
Safety, effectiveness, flow
11.Team away days Team functioning
Effectiveness, satisfaction, reduced
sickness, retention
25. 5 BIG ideas.
1. Choice
2. Core and Specific Partnership Work
3. Selecting Core Partnership clinician
4. Job Planning
5. Peer group discussion
26. #1 What is Choice?
• Choice appointment = first face to face contact
• Find out what child, youth and family wants
• Use clinical knowledge to collaboratively
formulate problem
• Choice is single session intervention
• Clinician and family design plan to help with
problem:
– Choice is enough and they can exit or
– Return to clinic for treatment matching problem or
– Refer to another agency or care provider for better
match
Slide content taken from CAPA.co.uk
27. Choice: menu of treatments.
• Establish treatment goals with clients
• Match goals with menu of treatments
– Methods: group, 1:1, in-home, family, school
– Intensity: outpatient, inpatient, acute care, day
treatment Intensive services
• Consider patient/family’s capacity for change
28. #2 Core and Specific
Partnership Work
Slide content from capa.co.uk
29. What is core partnership?
• If patient/family will stay at clinic after
Choice appointment, then go to Core
Partnership
– treatment matched to Choice-defined problem
and goals, i.e., family “pulls” care in
– assigned by reviewing who on team has skills
best suited
– evidence-based treatments effective across
wide range of problems, e.g. CBT
– Can be individual or group care
– CAPA model suggests average of 7.5
sessions
30. Specific Partnership
Specific:
• When a particular
technique,
assessment, or skills
is needed for specific
symptoms or
problems as a
complement to Core
work
• Treatment duration is
shorter or longer
Specific Time examples:
– Diagnostic
Assessments
– Cognitive
Assessments
Specific Clinics:
- OCD
- Eating Disorders
- Psychosis
- PDD
37. IWK Health Centre
• IWK Mental Health Program
- Mandate for service delivery across continuum
of care
- total of 400 allied professionals and support
staff providing care across multiple service
areas and 17 psychiatrists
- CAPA started April 2012 in outpatient teams
2015/16 Data:
42. CHEO
• CHEO Mental Health Program, Outpatient
Service:
– Psychiatry Dept. (3.4 FTE) provides all
psychiatric care
– 12.5 total FTE allied health professionals and
support staff
– 15/16: 1479 referrals to Outpatient; 8715
visits; all off site; Outpatient Eating Disorders
is separate
– In care partnership with the Youth Program at
The Royal Ottawa Hospital: Young Minds
Partnership
43. Progress to date
• Pre-CAPA: wait time to first appointment =
average 200 days
• Current wait time: 4.5 weeks
• Current wait time for Partnership
(excluding groups) = 8 weeks
• Skills and competencies assessment
identified following gaps:
– Trauma care, brief interventions, some group
therapies, family therapy
44. The Royal Ottawa Hospital
• The Royal is specialized mental health centre to
treat people with complex, serious mental illness
in Eastern Ontario.
• The Youth Program provides intensive,
specialized mental health services to 16-18
year-old youth with early onset major psychiatric
disorders or complex psychiatric illnesses
resistant to treatment.
• Number of clinicians and psychiatrists = 15
• Waitlist blitz – early 2015; CAPA March 2016
45. Progress to date
• Wait times:
– January 2015 ~ 18 months (blitz)
– March 2016 ~ 2 months
– Currently ~ 4 weeks
46. Progress to date
• Parent Choice experience (N = 16)
“Overall, the help I had here was good.”
All true 84.6%
Partly true 7.7%
Don’t know 7.7%
“Did you feel that people here listened to your concerns?”
Very much 92.3%
Pretty much 7.7%
“Was today’s session helpful for you?”
Very much 69.2%
Pretty much 15.4%
A little 15.4%
47. Client & Clinician Ratings/Choice
(N = 23)
Q1 – “How much were they/you curious about their/your
view point…?”
RESPONSE CLIENT CLINICIAN
None 0% 0%
A little 0% 0%
Some 8.7% 0%
A fair bit 8.7% 9.5%
A lot 39.1% 47.6%
Loads 43.5% 42.9%
48. Client & Clinician Ratings/Choice
(N = 23)
Q2 – “How much did they/you share their/your thoughts
and opinions for you to discuss?”
RESPONSE CLIENT CLINICIAN
None 0% 4.8%
A little 0% 0%
Some 13.0% 19.0%
A fair bit 21.7% 42.9%
A lot 52.2% 19.0%
Loads 13.0% 14.3%
49. Client and Clinician
Ratings/Choice (N = 23)
Q3 – “How much did they/you come to a share view as the
nature of their/your problems?”
RESPONSE CLIENT CLINICIAN
None 0% 0%
A little 0% 0%
Some 8.7% 0%
A fair bit 8.7% 9.5%
A lot 39.1% 47.6%
Loads 43.5% 42.9%
51. Key CAPA elements
• Systematic evaluation of progress: use data to inform
decision-making.
• Fidelity is critical.
• Mechanics done without philosophy change is “doing
to” our clients, not “engaging with” them.
• Need to build continuous skill development:
– Choice Clinic = pushing out the private practice model and
building trust.
– Team Peer Supervision = creating an environment where
clinicians can ask for help.
– Developing clinical capacity in specific clinics to strengthen
core skills.
53. Lessons learned.
• Program administration needs
to be actively supporting
CAPA
• Achieving flow of patients
means radically new thinking.
• Change will come in waves.
• People may accept CAPA and
then drift back to old ways.
• The power of families as
collaborators is freeing.
• Stick with it.
• Share what you’ve learned.
• Find mentors and stay in
close communication.
• Fidelity to model is critical.
54. Resources
• All the CAPA ideas and concepts presented
today were developed by Drs. Steve Kingsbury
and Ann York.
• Please see the http://www.capa.co.uk/ website
for more information or refer to their publication:
The Choice and Partnership Approach: A
Service Transformation Model (2013)