Friday, Oct. 20
10:45 – 11:45 (1 hr)
Meeting Room: Junior Ballroom AB (3rd floor – North Tower)
Kamini Vasudev*, MRCPsych (UK)

CanMEDS Roles:

1. Collaborator
2. Leader
3. Health Advocate

At the end of this session, participants will be able to: 1) Describe an interdisciplinary team-based model of mental health care in outpatient service; 2) Design a referral form for outpatient services to efficiently assess patient needs; and 2) Evaluate hospital-based outpatient services with quality indicators.

Before the pandemic, the General Adult Ambulatory Mental Health Services at Victoria Hospital delivered urgent and nonurgent psychiatric care for adults aged 18 to 64 years through a physician-first-service delivery model. In the context of suboptimal physician resources and the consequences of the COVID-19 pandemic, a crisis backlog of 812 nonurgent psychiatry referrals accumulated between August 2020 and March 2021 with a predicted wait time of more than a year to see a psychiatrist. Process mapping was conducted, and quality improvement (QI) change ideas were applied with PDSA cycles. Redesign of the referral form, implementation of an interdisciplinary team-based model of care, introduction of a virtual application tool and standardization of physician contracts were some of the QI strategies that decreased wait-list time from an average of over 12 months to five months. In addition, the capacity for new consults seen per nonurgent psychiatrist each week increased from 2 in 2020 to 5.3 in 2022. This project is the first of its kind in Canada and was implemented without the addition of any project management resources or additional staff. The presenters will share their experience implementing the above interventions so that the attendees may replicate the same at other hospital-based outpatient services across Canada and other countries to improve access to mental health care. The workshop will begin with an interactive discussion on a clinical scenario followed by three presentations covering a) the problem faced, b) interventions made, and c) outcomes achieved.

References:

1. Liddy C, Moroz I, Affleck E, et al. How long are Canadians waiting to access specialty care? Retrospective study from a primary care perspective. Can Fam Physician 2020;66(6):434–444.
2. Chen JA, Macchiano S, Beckmann D, et al. Implementing multidisciplinary, team-based care in an academic outpatient psychiatry department. Psychiatr Serv 2022;73(11):1290–1293.