1. Karen Burgess, Edward Brunner, Colleen Dingwall, Margaret Green, Raquel Almeida

2. * The only tertiary care program in the province offering treatment for individuals over the age of 18 living with an eating disorder * Offer assessments, consultations, inpatient and outpatient treatments, follow up * Multidisciplinary team

5. Program Capacity In Patients26 per year Weekly CBT16 x 2 = 32 per year Day Program 10 x 12 weeks = 44 per year Capacity corrected for dual attendance (20) and spots taken by individuals with chronic symptoms (5-7) reduces capacity for new referral to 75 – 80

6. * Inspired by Dr. Ron Remick’s presentation at QI 2015 * Group Medical Appointments * Tremendous impact on waitlist * The needs of the patients were met in a group setting

7. We recognized a large portion of nursing time is devoted to individual follow up appointments. If we use Dr. Remick’s format, we could reduce the amount of time we are in follow-up appointments. If we reduce our time commitment in individual appointments, we can increase time devoted to assessments and reduce wait times

8. * Follow Up Group * 2 Nurse Therapists * 3 – 6 individuals who have completed treatment * Shared appointment with a structure format * Participants will review goals, behaviours-cognitions-emotions are summarized and strategies discussed * New goals are set and tools/resources are provided

9. * Letters sent to patients in individual follow up and in day program which highlighted 1. We were very excited about the change 2. We were mindful change can be difficult 3. We were confident we would continue to provide excellent care 4. We believe we can help more individuals and reduce our wait times 5. We were available to answer questions and address concerns * Forms developed and ready to use 1. Follow-Up Treatment Contract 2. Follow-Up Feedback Forms * Toolbox of Resources

10. Groups are well attended and patients continue to rebook New group members are welcomed Senior group members assist with the transition Feedback is limited, but generally positive, meeting identified needs of the participants Participants have identified shame as a barrier in a group setting Six months in to groups, Nurse Therapists observe recovery trajectories to be the same or better in a group format

11. 1. Spend less time in individual appointments (Follow-Up Groups) 2. Increase number of assessments and stream patients into new orientation and pre- treatment care format 3. Involve more team members