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Implementation of a new staged screening and assessment process for addictions

For information about the first phase of this project please see eenet.ca/dtfp/best-practice-assessment-procedures-project.

Project lead:
Kim Baker, Implementation Supervisor, Provincial Systems Support Program, CAMH

Project description/objectives:

  • The Best Practice Screening and Assessment Project gathered the best available evidence and feedback from key stakeholders to develop and pilot test an evidence-based and standardized staged screening and assessment process for LHIN-funded substance use services in Ontario.
  • This staged process helps identify both substance use and mental health issues among clients seeking substance use services, increasing appropriate referrals and helping in treatment planning.
  • Based on the evidence and stakeholder feedback, the project’s Advisory Committee recommended that the protocol and tools be rolled out across Ontario.

Project Objectives:

  • Improve the screening and assessment of clients receiving substance use services through the implementation of a staged process across Ontario.
  • Implementation that will include, coaching, fidelity monitoring, evaluation and sustainability planning..

Value for the System:

  • More consistent, evidence-based approach to service.
  • Enhanced ability to identify and assess co-occurring mental health issues.
  • Comprehensive assessment and detailed, integrated reports support matching to a treatment setting with appropriate resource intensity.
  • Detailed client profiles based on information generated through assessment can be used for gap analysis and planning at the agency and Local Health Integration Network (LHIN) level.
  • High potential for outcome monitoring.

Supported Implementation:

This evidence-based staged screening and assessment process is being rolled out across Ontario using implementation science, a purposeful and effective framework for implementing new practices. The implementation process will include:

  • Development of LHIN-specific implementation plans.
  • Training and capacity building for the new process.
  • Coaching support for agency implementation.
  • Opportunity to provide feedback on the implementation and related supports through participation on LHIN and/or agency implementation teams, contributing to evaluation.

Frequently Ask Questions:

What is the new staged screening and assessment process?
This new process involves an evidence-based, staged approach for screening and assessment of individuals accessing service within the addiction treatment system. This staged approach responds to the need for an integrated process that is effective at:

  • Identifying co-occurring mental health problems;
  • Providing better matching to the appropriate level of service;
  • Creating a solid foundation for treatment planning; and
  • Providing detailed agency and LHIN-level client profiles for planning and evaluation.

The tools used in the staged screening and assessment process are as follows:

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Who will be involved?
The process is being implemented within LHIN/Ministry of Health and Long-Term Care funded addiction service agencies across Ontario. Implementation is beginning in approximately half of the LHINs with the other half engaged in planning for implementation in 2016.

How will it be implemented?
Implementation Science (IS), a proven approach to moving evidence-based research into practice to improve client outcomes, will be employed for the roll out of the new staged screening and assessment process. IS involves purposeful, planned and active implementation, supporting fidelity and sustainability. The supports for training, coaching and fidelity monitoring available through IS increase an organization and staff’s ability to effectively implement and sustain the new practices.

LHIN-level implementation plans will be developed collaboratively with LHIN leads and local system planning tables, taking into account local system characteristics such as central/coordinated access and other tools in use. LHIN-level implementation teams, comprised of local representatives and project staff, will be established to guide and support the process.

What supports are available?
Staff will be provided with training on the full suite of tools and will attain certification as site interviewers of the GAIN Q3 MI ONT. Project coordination, evaluation and knowledge exchange support will be provided by the central DTFP Implementation Team within the Provincial System Support Program at CAMH. Implementing agencies and staff will receive ongoing support from Regional Implementation Coaches.

What kind of training is required?
Training on the process will take place through a combination of web-based and in-person training. Initial training for early adopter agencies will be delivered by the DTFP Implementation Team. A group of trainers will be established and supported within each LHIN to provide ongoing training and sustainability. Initial training is anticipated to begin in late September in the first wave of LHINs.

Who can I contact for more information?
For more detailed information regarding the Staged Screening and Assessment project and provincial implementation, please contact: Angela Martella, Implementation Coordinator, at Angela.Martella [at] camh [dot] ca or 416 535 8501 ext. 32951.

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UPDATES

Staged Screening and Assessment Implementation Ramps Up

Posted January 99, 2017

All 14 LHINs are actively engaged in various stages of planning to implement the new staged screening and assessment (SS&A) process. To date:

  • 135 organizations have been involved in training;
  • Over 700 staff members have participated in the screening tools orientation webinar (GAIN-SS, MMS, POSIT);
  • More than 67 full-day assessment tool trainings have taken place with over 700 staff (GAIN Q3 MI ONT);
  • Almost 400 staff have successfully completed the three-month Site Interviewer certification process;
  • There are 90 fully certified trainers in communities across the province and another 24 engaged in the certification process.

The project team is coaching agencies through the SS&A implementation process, so that the new mandated tools will be embedded in daily practice. They’re also evaluating the implementation process, gathering feedback from trainees, trainers, and LHIN mental health and addictions leads to ensure they’re receiving the implementation support they need.

Next steps
Moving from successful certification to active implementation is a major focus of the next phase of the project.

The project team is developing more resources to help agencies and clinicians implement and embed the SS&A process in their day-to-day work. Among these resources are:

  • an implementation guide that acts as a companion to the training,
  • a clinical interpretation webinar to support use of the GAIN Q3 MI ONT reports in treatment planning, and
  • quick video tutorials on specific aspects of tool administration.

The team is also working with DATIS to extract data gathered with the screening and assessment tools. In the coming months, the team will share information such as the number of assessments completed in agencies across the province as well as the clinical profile of individuals accessing care. This information will help us better understand the complex needs that the system is responding to.

Implementation coaches will continue to engage with agencies to support their efforts to embed the tools in their workflow processes.

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Webinar recording: Improving substance use treatment in Ontario – The DTFP implementation projects

Posted July 27, 2016

Watch the webinar recording of the sixth webinar in Health Canada’s Ontario DTFP webinar series, with project lead Kim Baker participating as one of the panelists. This webinar took place on Thursday, July 21, 2016.

 In this DTFP webinar, you’ll learn about:

  • Early impacts of the Ontario implementation projects
  • How the projects are aligning with priorities in the provincial mental health and substance use treatment system
  • Innovative ways to sustain this work

The projects:

The panelists:

  • Kim Baker, the Centre for Addiction and Mental Health
  • Janis Cramp, Addictions and Mental Health Ontario
  • Renee Linklater, the Centre for Addiction and Mental Health
  • Karen Urbanoski, Centre for Addiction Research of British Columbia, University of Victoria

View the recording here and view the slides here.

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Local trainer certification for SS&A continues across province

Posted July 7, 2016

The orientation, training, and certification in the new staged screening and assessment (SS&A) has been revised and enhanced based on feedback from early participants.

Meanwhile, regional coaches continue to work with agencies to develop agency-level action plans to implement the SS&A and to support staff as they move through training.

To date, 12 LHINs have been engaged in implementation planning. The remaining two will start in early July.

Local trainer certification continues across the province with about 110 addiction agency staff across 12 LHINs having achieved or in the process of attaining GAIN Q3 MI ONT trainer certification. Emphasis has been placed on supporting this group through their certification process and building their capacity as they start to deliver training in their local communities and undertake the quality assurance process that follows.

Training of direct service providers is underway in 10 LHINs with over 80 agencies involved to date. More than 360 staff have participated in training and over 150 have already achieved site interviewer certification which allows them to use the tool in their clinical practice.

The SS&A team also presented a project update at the Addictions and Mental Health Ontario 2016 conference in May. Check out the slides here.

Next steps
The team is finalizing the SS&A implementation guide. They’re also developing a webinar on interpreting the clinical reports generated from the GAIN Q3 MI ONT assessment, which will be of particular interest to residential providers who will receive referrals based on these reports.

As part of ongoing evaluation efforts the team is conducting focus groups, surveys and interviews, in the weeks ahead, with various stakeholders who have been involved in the SS&A implementation

Focus will also be on scaling up in existing LHINs, planning in LHINs just underway and sustainability planning provincially in the months ahead.

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Join the latest webinar in our Drug Treatment Funding Program series!

Posted June 27, 2016

Kim Baker, project lead for the Implementation of a New Staged Screening and Assessment Process for Addictions DTFP project, will join a panel of other Ontario project leads for a webinar hosted by EENet.

Date: July 21, 2016
Time: 1:00 – 2:30 PM (EDT)

Register here! Spaces are limited! To see the flyer click here.

In this DTFP webinar, you’ll learn about:

  • Early impacts of the Ontario implementation projects
  • How the projects are aligning with priorities in the provincial mental health and substance use treatment system
  • Innovative ways to sustain this work

The projects:

  • Best Practices in Peer Support Services
  • Trauma-informed substance use screening and assessment tools for First Nations and Inuit peoples
  • Implementation of a New Staged Screening and Assessment Process for Addictions
  • Implementation of Ontario Perception of Care for Mental Health and Addictions
  • Internet-based interventions (IBIs) for Substance Use in Youth

The panelists:

  • Kim Baker, the Centre for Addiction and Mental Health
  • Janis Cramp, Addictions and Mental Health Ontario
  • Renee Linklater, the Centre for Addiction and Mental Health
  • Karen Urbanoski, Centre for Addiction Research of British Columbia, University of Victoria

To learn more about the DTFP projects visit our website.

This event is made possible thanks to funding from Health Canada’s Drug Treatment Funding Program.

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Trainer certification is underway

Posted March 23, 2016

Engagement and implementation is underway across Ontario for the new Staged Screening and Assessment process!

Eight of the 14 LHINs are fully engaged in local LHIN GAIN Q3 MI ONT trainer certification. These trainers will help ensure the new process is scaled up and sustainable in their communities.  In most of these LHINs, trainers have already started to support the training and certification of other service providers. DTFP implementation coaches are working with organizations to support agency level implementation.

The DTFP Evaluation Coordinator has consolidated feedback from surveys and ongoing discussions with early adopters, which has resulted in changes being made to improve training and implementation processes.

The DTFP team has also started engaging the remaining six LHINs as a first step towards context specific implementation planning. Two GAIN Q3 MI ONT train-the-trainer sessions are being organized for the next wave of local trainer candidates. To date, about 90 service providers are at some stage of the trainer certification process.

In the next few months, work will continue to support trainer candidates to attain certification, agency implementation planning, and LHIN planning in the new wave of LHINs.  The CAMH implementation team will also be working on sustainability plans for the provincial implementation.

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Roll out of new staged screening and assessment process begins

Posted December 8, 2015

The new staged screening and assessment process is now being rolled out across Ontario, starting with about half of the Local Health Integration Networks (LHINs).

Key activities underway include:

  • Implementation plans that take into account the community context are in development in the first wave of LHINs.
  • A group of about 65 service providers are in the process of becoming certified trainers for the assessment tool (GAIN Q3 MI ONT). This group will support scale-up and sustainability within their respective LHINs.
  • The DTFP implementation support team is facilitating training for a small group of early-adopter clinicians from selected agencies.

Important next steps include engaging with remaining LHINs, finalizing the implementation guide currently in development, addressing data-collection challenges, and refining the materials and approach used to train service providers based on feedback from early adopters.

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New staged screening and assessment process: How does this impact agencies and clients?

Posted November 13, 2015

Watch the first webinar in the Health Canada Drug Treatment Funding Program (DTFP) Ontario webinar series! This webinar provides:

  • An overview of the evidence-based staged screening and assessment process and the new tools;
  • A look at the reports that will be generated by the electronic administration of the assessment tool;
  • An update on the implementation status and plans (including training and certification); and
  • Information about impacts to the system, agencies, and clients.

To view the recording click here. To see the slides click here. You can also watch the videos that were shared during the webinar by clicking below.

Presenter:
Kim Baker, Implementation Supervisor, Provincial Systems Support Program at the Centre for Addiction and Mental Health (CAMH)

VIDEOS:

1. Experience with implementing the new staged screening and assessment (SSA) process from EENet on Vimeo:

2. Clinical impact of the new staged screening and assessment (SSA) process from EENet on Vimeo:

3. Anticipated system impact of the new staged screening and assessment (SSA) process from EENet on Vimeo:

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Check out these videos!

Posted October 30, 2015

Two short videos are now available. In the first clip, Brian Rush, DTFP Consultant; Scientist Emeritus, Social and Epidemiological Research Department, CAMH, discusses the need for refreshed staged screening and assessment tools in Ontario. In the second, Brian highlights the value of a staged process. Check out the videos below:

 

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Join this DTFP webinar!

Posted October 27, 2015

Join this FREE, one-hour, knowledge exchange session via telephone and webinar to explore what Ontario is doing to enhance the substance abuse treatment system!

This webinar is part of a series to connect stakeholders across our province, and other provinces and territories, as we work
to improve our substance abuse treatment system.

  • This workshop will include:
  • An overview of the evidence-based staged screening and assessment process and the new tools;
  • A look at the reports that will be generated by the electronic administration of the assessment tool;
  • An update on the implementation status and plans (including training and certification);
  • Information about impacts to the system, agencies, and clients.

Join us if your agency will be using or receiving these tools.

This workshop is aimed at agencies implementing the tools, but also is open to all stakeholders of EENet, the Ontario substance use treatment system, and our national partners.

Please note that the webinar will be recorded and posted on the project’s website following the presentation, here:

Date: Thursday, November 12, 2015
Time: 1 to 2 pm EST
Maximum capacity: 150 participants

To register click here. To learn more see the flyer.

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Ontario DTFP Projects Hold Knowledge Exchange Event

Posted October 20, 2015

The Ontario DTFP projects participated in a knowledge exchange launch event on October 19, 2015. Over 80 participants from across the province joined to strengthen collaborative efforts to enhance Ontario’s addiction treatment system.

To see the poster presented by the Implementation of a New Staged Screening and Assessment Process for Addictions project click here.

For more information, visit eenet.ca/dtfp/evidence-exchange-network-eenet-2.