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Quarterly Report on Strategies for Healthy Communities

This report provides an overview of the strategies implemented in the second quarter of 2015/16 by VP Michael Redenbach to improve mental health and addiction services. The report focuses on integrated health services, outpatient and inpatient care, crisis and outreach redesign, and the provincial improvement targets.

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Quarterly Report on Strategies for Healthy Communities

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  1. Vision: Healthy people, families and communities. VP Quarterly Report on Strategies Q2 – 2015/16 VP: Michael Redenbach – Integrated Health Services Mental Health &Addictions Multi-year Plan

  2. Portfolio Overview Mental Health & Addiction Service Line • Outpatient Adult Mental Health Services • Outpatient Child & Youth Mental Health Services • Inpatient Mental Health Services • Outpatient & Inpatient Addiction Services • KOT

  3. Multi Year Strategic PlanVP leading on:

  4. Balanced Care Model • Pooled Referrals • All Psychiatrists, contract and fee-for-service, will participate • Patients will get an appointment with the next available psychiatrist • Use Mental Health triage and intake service so that other services are also activated • Goal is to reduce wait times and wait lists

  5. Psychiatry Re-design • Consultation Liaison Team to provide services throughout hospital to other acute care units • Five Hospitalist psychiatrists devoted to inpatient care • Better, more timely inpatient care with improved family dialogue and coordination of care with other services • Better discharges and hand-off to community services.

  6. Crisis and Outreach Redesign • Redeploy staff from three small teams, to create one team to provide better access after hours, and to provide outreach and support to high risk and vulnerable persons • Renamed Community Outreach and Support Team (COAST) • Initiate Police and Crisis Team (PACT) aimed at supporting people in crisis, and diverting them from jail or emergency department

  7. SPMI Redesign • Reorganize programs devoted to people with severe and persistent mental illness • Provide concurrent services for people with an addiction and a mental illness • Renamed Community Recovery Services

  8. Mental Health and Addictions Multi-year Plan 2015-16 Provincial Health System Outcome • By March 2019, there will be increased access to quality mental health and addictions services and reduced wait time for outpatient and psychiatry services

  9. Mental Health and Addictions Multi-year Plan 2015-16 Provincial Improvement Targets • By March 31, 2016, waits for contract and salaried psychiatrists will meet benchmark targets to a threshold of 50% • By March 2016, 85% of Mental Health and Addictions clients will meet the wait time benchmarks based on their triage level. • By March 31, 2017 wait time benchmarks for mental health and addictions will be met 100% of the time.

  10. Mental Health & Addictions Multi-year Plan Outcome Measure Percentage of Clients Meeting the Triage Benchmarks in Psychiatry Programs Triage Benchmarks Very Severe - 24 hrs Severe - 5 working days Moderate - 20 working days Mild - 30 working days Goal - 85%

  11. Mental Health & Addictions Multi-year Plan Outcome Measure Percentage of Clients Meeting the Triage Benchmarks in Addictions Outpatient Triage Benchmarks Very Severe - 24 hrs Severe - 5 working days Moderate - 20 working days Mild - 30 working days Goal - 85%

  12. Mental Health & Addictions Multi-year Plan Outcome Measure Percentage of Clients Meeting the Triage Benchmarks in Outpatient Mental Health Triage Benchmarks Very Severe - 24 hrs Severe - 5 working days Moderate - 20 working days Mild - 30 working days Goal - 85%

  13. Status of Strategy ImplementationSuccesses • Successes/What is working • Value stream mapping, daily visual management, using PQA and other data to better understand the service line issues • Distributed Leadership in projects – tap into the expertise of many, leadership characterizes the team • Implementation Science – set up projects to sustain outcomes • Cross-functional work and support especially with ED and IT • Collaborative work with Ministry of Health • Patient partnership with Canadian Mental Health Association

  14. Status of Strategy Implementation – Challenges & Risks • Challenges/Gaps/Risks • Challenges: • Communication – we don’t do enough • Change Management – we don’t always get it right • Demand from other areas, both internal and external to the region • Risks: • Change fatigue • Loss of momentum in projects • Temporary dip in capacity at some points of program change • Meeting wait time target must not compromise quality

  15. Next Steps • Next Steps • Continue work on referral management, psychiatry redesign, crisis and outreach services, and the program for people with severe mental illness • Collaboration with IT on Clin docs project • Continued implementation/refinement of daily work boards (daily visual management) and cascade metrics that facilitate problem solving • Prepare for major changes to Mental Health Services Act (proclamation expected Fall 2015 sitting) • Work on smaller point improvements using Lean tools – med error reduction on inpatient

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