Transcript Document

Action Planning
Module Structure
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How will you be supported: Regional Support Team
 Structure
› Physician Practice Leaders
› Specialist Physicians
› MCFD Clincians
› School Counsellors
› PSP Coordinators
 What we do
› Co-facilitate learning sessions
› Provide Action Period support
 Funded by General Practice Services Committee (GPSC) and Shared Care
Committee (SCC), joint committees of BCMA and Ministry of Health
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Measures
Aim
Change Ideas
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Aim
 Within 8 months, we aim to
improve child and adolescent
mental health in participating
BC practices as evidenced by
improved scores on KADS,
SCARED and SNAP and CGI.
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We will focus on:
 Early identification and diagnosis of anxiety, depression and ADHD
 Appropriate use of various evidence-informed treatments anxiety,
depression and ADHD
 Appropriate application of standardized methods of measurement in the
care of mental disorders in children and youth
 Enhancement of physician and MOA knowledge about and awareness
of community mental health resources for children and adolescents
 Enhanced family physician collaboration with community partners in the
mental health care of children and adolescents
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We will focus on: (continued)
 Enhancement of physician and MOA knowledge about and
awareness of community mental health resources for children and
youth
 Enhanced family physician collaboration with community partners
in the mental health care of children and youth
 Improve experience of the health care providers, patients and
their families
Collaboration
with specialist
physicians,
Schools, MCFD
CYMH and other
clinical and
community
partners
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Measures
 # of patients screened positive/diagnosed with the
anxiety, ADHD, and depression
 % patients screened positive/diagnosed with anxiety,
ADHD or depression (“identified”) who are treated with
protocol-driven, non-pharmaceutical interventions
 % of “identified” patients who are treated with protocoldriven medications
 % of “identified” patients who experience improved
health outcomes after at least 3 months of treatment
as evidenced by changes in scores
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Moving forward… with measurement
“If it is not measured, it's not medicine.”
- Dr. Marshall Dahl
“Some is not a number, soon is not a time.”
- Dr. Don Berwick
“Without data, everyone is perfect.”
- Dr. Paul Murray
“Data drives improvement.”
- Dr. Neil Baker
“The pride in which you wallow, without data may be hollow.”
- Dr. Dan MacCarthy
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Data Collection Sheet
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Action Period Requirements: Example Depression
 Screening using Mental Health Screening Questions and
assessment with KADS-6, SNAP-IV or SCARED (4 patients)
 Created a registry including child and youth with positive
screen/diagnosis
 Provided psychotherapeutic treatment to 2 patients
 Provided pharmaco-therapeutic treatment to patients, as required
 Retested KADs on subsequent mental health visits for patients
with a positive screen/diagnosis of Depression
 Recorded CGI scores at every patient visit
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Changes to try
 Identification and screening of children and youth
 Creation of a registry
 Treatment processes
 Team-based care - GP’s, Schools, other care
providers
 Linking with community programs and supports
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Example: Registry
What is it?
What types are there?
 A list
 Paper list
 A database
 Excel spreadsheet
 Binder
What is it used for?
 Flagged chart
 Tracking best practice
 EMR based
 Proactive follow-up
 Hollander Analytical Services
Tool
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Key Resources
 Child and Youth Action Planning Form
 PSP website: http://www.pspbc.ca
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Change: Screening in GP office – Example:
Anxiety
PLAN:
 Question:
› How long will facilitating the first competition of the SCARED screening tool
take in a GP visit?
 Who, What. Where, When:
› When the Smith family comes in on Tuesday we will ask them to complete
the SCARED screening tool in the waiting room prior to meeting with the
GP.
 Data to Collect:
› How long will it take to complete the form?
› How long will going over the results with the family take?
› What additional information may be needed from the
school?
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When you get home
DO – complete your test
STUDY – examine the results
ACT
- What will your next step be?
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Just Try It!
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Cycle 3: Try the new process on all patient with
suspected anxiety for 2 weeks, does this work on
full scale?
Cycle 2: Test administering the SCARED in a new way based
on lessons learned. Test MOA involvement in giving out and
scoring the screen
Use of Screening Tools
Cycle 1: Test having completing SCARED screen with 1 patient. How long does
the screen take? How will you score it? How will you discuss the results with the
family?
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Action Period Planning – Team Activity
 With your community team (e.g. GP, MOA, School Counselor,
Mental Health Clinicians…), discuss what changes you will test in
the action period
 Fill out the action planning form
 Write the PLAN for your first Plan, Do, Study, Act cycle
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When in doubt – Ask the Experts!
Action Period Expectations
 Try tests of change.
 Measure and track your progress.
 RSTs practice visits.
Support throughout the action period you can expect:
Practice visits from the coordinator.
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