1. 2015 AGHPS SUMMIT Preliminary Thoughts From Schedule 1 Leaders Heather Scott, Director Mental Health & Addictions Niagara Health Systems’ Impetus for Change Towards Integrated Care Pathways Precipitating Events a)New Hospital b)Readmission Rates (include 5ED Visits+3 Admissions Annually) c)Hospital Initiated Standard Work d)Suicide Risk Assessment Quality Improvement Planning Process a)Reviewed existing ICPs – isolated core principles b)Selected Focus Areas: i.Bipolar Type II ii.Psychosis iii.Substance Use

2. 2015 AGHPS SUMMIT Preliminary Thoughts From Schedule 1 Leaders Heather Scott, Director Mental Health & Addictions Important clinical/administrative elements and challenges that we needed to consider and will be necessary key considerations for QBP creation. Hospital resources Psychiatric Resources Technological capacity (i.e. EMR, data limitations) Culture Change Management

3. 2015 AGHPS SUMMIT Preliminary Thoughts From Schedule 1 Leaders Heather Scott, Director Mental Health & Addictions NHS needed to standardize certain structural functions before any advanced practice could be overlaid NHS Necessary Work In Preparation for Clinical Care Pathways: Organized Team Structure Pod Nursing Developed Acute Care Pathway Standardized Unit processes and data collection Culture Shift from Medical Model to True Interprofessional Model To support that provided focused Champion to assist with roll-out Established Coordination points Rapid Rounds Grand Rounds Data and Quality Audit Tools Consider an accurate tool with easily accessible information Education New Staff Orientation, ongoing staff education and CME’s all related to evidence based practices related to the 3 focused areas Pace Layered approach to implementation Leadership Steering Committee Regional Psychiatry

4. 2015 AGHPS SUMMIT Preliminary Thoughts From Schedule 1 Leaders Heather Scott, Director Mental Health & Addictions Key Considerations for QPB Creation: Availability of Best Practice/Content Experts Clinical, educational and change management Graduated Rollout in multiple types of centers Ensure a quality control system and open communication - learn from each implementation Baseline System Technical Capability Do not make assumptions Support system for change management Consider fully the required resourcing needs