www.pspbc.ca

Action Planning

Aim Measures 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 4

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 5

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 protocol-driven medications  % of “identified” patients who experience improved health outcomes after at least 3 months of treatment as evidenced by changes in scores 6

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 7

Measurement 8

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 9

Example: Registry What is it?

 A list  A database What is it used for?

  Tracking best practice Proactive follow-up What types are there?

 Paper list      Excel spreadsheet Binder Flagged chart EMR based Hollander Analytical Services Tool 10

Key Resources  Child and Youth Action Planning Form  PSP website: http://www.pspbc.ca

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Change: Screening in GP office 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!

A S P D A S P D Cycle 3

: Try the new process on all patient with suspected anxiety for 2 weeks, does this work on full sclae?

A S P D 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? 14

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 15

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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