Additionally, the Central East LHIN ACT network’ ACTT Quality Improvement initiative highlighted here https://www.eenetconnect.ca/top...-to-support-recovery has published a progress report - Assertive Community Treatment “(ACTT) TOGETHER” - IMPLEMENTATION PHASE: Year 1 Progress Report (2014-2015).
Along with it’s descriptions of integration of ACTT in the broader mental health system particularly hospitals, and practice improvements; the implementation of “Stepped Care” within each of the network's ACTT teams, utilizing stepped care nurses with clients within each team is explained.
The evaluation report provides details of ATR score groupings for the clients transitioned to Stepped Care, client experience questionnaire and focus groups.
Here is the executive summary and the report has been uploaded below.
In April 2014, the Assertive Community Treatment Teams (ACTT) across the Central East LHIN began the implementation of recommendations that resulted from the 2012/2013 ACTT Together Quality Improvement Initiative (QII). The goals of the three-year implementation phase were to increase overall capacity of the eight ACTTs by implementing a Stepped Care
Model into each Team, allowing for the admission of new clients into ACTT, and to promote and improve communication and collaboration between ACTTs and other Health Service Providers.Over the course of the first year of implementation (April 1, 2014 to March 31, 2015), all eight CE LHIN ACTTs implemented the majority of recommended standards and best practices from the QII, which included process improvements to intake and referral, treatment, hospital
relationships, and discharge. Each team implemented a Stepped Care Model into their practice, which saw the addition of one Stepped Care Nurse to each team, who would oversee the transition and support of clients from “regular”, high-intensity ACTT services, to lower intensity
services within ACTT. These clients, while identified as successful in “regular” ACTT, are not yet ready for Case Management or less intensive services outside of ACTT.During year one of implementation, the eight CE LHIN ACTTs transitioned a combined 90 clients into Stepped Care, while admitting an additional 104 clients to their “regular” ACTT rosters. These newly admitted ACTT clients had a combined total of over 17,700 psychiatric hospital bed days over two years prior to ACTT, and represent among the highest acuity of users of the System. It was anticipated that the capacity of CE LHIN ACTTS would increase by 200 clients by 2017, and the client numbers to date represent approximately 50% of this number in the first year of implementation alone. Over 95% of clients that transitioned into Stepped Care remained in Stepped Care over the course of the year (i.e., did not decompensate back to “regular” ACTT services). Feedback from Stepped Care clients, gathered through questionnaires and focus groups, highlighted extremely high satisfaction ratings with the Stepped Care experience and transition to the new Model.
The next phase of this project (years two and three) will see the evaluation,improvement, and sustainability/growth of the work completed to date. This next phase will include ongoing client data collection and progress reports, measure of success surveys and peer reviews, continued client satisfaction questionnaires/focus groups, and ongoing communication with various stakeholders such as local area hospitals/agencies and the Ontario ACTT Association, to continue collaboration and knowledge sharing.