Message from the Board Chair
SickKids CCMH and SickKids CCMH Learning Institute: Providing quality care and education
Over two years ago, at the time of integration, SickKids leadership and the Board of SickKids CCMH and SickKids CCMH Learning Institute made important commitments to ensure the success of SickKids CCMH and SickKids CCMH Learning Institute. Along with the leaders of those organizations, the Board and SickKids leaders have delivered on this promise, improving access to quality care and performance of our clinical services, and increasing the scope and volume of training that we offer to our many partners.
The leaders of the centre and institute are proud of the work done by their teams. I invite you to review the letters and stories below that describe the impressive accomplishments of the past year.
I would like to thank our former CEO and Board Chair, Dr. Michael Apkon, and SickKids’ interim CEO, Dr. David Naylor, for their vision and support. I am honoured to step into the role of Board Chair and am pleased to welcome Dr. Ronald (Ronni) Cohn, President and CEO of SickKids. We are looking forward to working with Ronni and our partners in the mental health community to continue to build our vision of a more seamless health-care system, bridging hospital and community.
Chair, Board of Trustees
SickKids Centre for Community Mental Health
For the SickKids Centre for Community Mental Health Board
Message from the Executive Director, SickKids CCMH
Our unrelenting drive to increase access to children’s mental health care services
SickKids CCMH has completed its second year since the integration with an unrelenting focus on our commitment to increase access to high-quality children’s mental health treatments and better address the large unmet needs of the many children and youth in our city and province. We are pleased that after having introduced a culture of evidence-based care, quality improvement and measurement, the results now speak for themselves. Since 2017, we have reduced wait times to service by an average of 40 per cent. By introducing additional clinical service lines, we have more options for choice of treatment for families; these options have supported our wait time reduction strategy but also allowed for better matching of treatment intensity to client and family needs. We have improved safety for clients and staff across all programs and campuses through environmental improvements, the introduction of Caring Safely, and better tracking of safety events where there are key learnings that inform future planning. This year, we completed the review of our intensive and residential services at SickKids CCMH and arrived at the decision to decommission the property known as “the Farm” and update our Toronto-based intensive services to better reflect the preferences of our youth – we are looking forward to the implementation of our new model of care over the next 18 months.
We are in a dynamic health-care environment with children’s mental health moving into the Ministry of Health and we see a focus on child and youth mental health across all levels of government. With our focus on client-centred care, quality, measurement and participating in innovative partnerships, SickKids CCMH is well-positioned to continue its journey to improved performance, and achieving its vision of delivering the highest quality care, training and research in the children’s mental health sector.
As I reflect on the SickKids integration and the events of the past two years, it is inspiring to see how much has been accomplished through this innovative relationship between the largest paediatric specialty hospital in the country and a large children’s mental health agency in one of the most dynamic, multicultural cities in the world. It has been an exciting, productive two years; my sincere thanks to our clients and families who have entrusted us with their care, our very hard-working staff and leadership team at SickKids CCMH, and our Board who have provided unwavering support to this important work.
Brain and Mental Health Program, SickKids
and SickKids Centre for Community Mental Health
For the Senior Leadership Team, SickKids Centre for Community Mental Health
Message from the Lead Executive, SickKids CCMH Learning Institute
Increasing our training opportunities for mental health care providers means more support for children, youth and adults
As the number of individuals requiring mental support grows, so too does the need for trained mental health professionals. At SickKids CCMH Learning Institute, our goal is to provide professionals with the highest quality education in evidence-based best practices in the treatment of mental health. This has been an exciting year as SickKids CCMH Learning Institute provided training to over 2,000 professionals, a 22 per cent increase from the previous year. This included adding 20 new courses and delivering over 80 training sessions onsite and across Ontario. This year also marked an important milestone as SickKids CCMH Learning Institute delivered its first-ever webinar training. With the inclusion of eLearning, professionals from across the globe can now easily access our leading-edge curriculum, enhancing our global impact within the mental health community.
At SickKids CCMH Learning Institute we strive to meet the training needs of the community. In 2018, SickKids CCMH Learning Institute led three focus groups with representatives from 12 children’s mental health agencies. These sessions provided valuable information to help inform new course topics that align with the educational needs of mental health practitioners and the community. In addition, the SickKids CCMH Learning Institute Advisory Board was launched in February 2018. This forum of key community partners has been instrumental in providing strategic guidance, leadership and identifying key topics and experts in the mental health sector.
We look forward to our continued growth and innovation as we expand our training opportunities across our community, Ontario, and beyond.
Vice President Education & Academic Practice, SickKids
Lead Executive, SickKids CCMH Learning Institute
Highlights from a successful year
Reorganizing intensive services to meet client need
By Neill Carson, Clinical Director and Site Lead
The leadership at SickKids CCMH spent a lot of time during the past year looking at the way our services are structured. We wanted to figure out whether the services we were offering really met the needs of our clients. On the one hand the answer was yes: by diversifying our outpatient services we respond both to clients with severe and long-term problems and to those who just need a short-term intervention or even simply some information. Through our prevention services we continue to touch more than 7,000 lives a year. Both our intensive service lines continue to respond effectively to children and young people with more complex situations.
However, use of our residential services is very low even though the rate of intensive service need in the city and across the sector is increasing. The fact is that what we offer in our intensive youth services does not completely match what our clients were seeking and what the literature tells us is most helpful: community-integrated, day-based services with strong transition supports. We also learned that many of our colleagues across the sector were having similar experiences.
So it was that in April 2019 we collaborated with our lead agency, and with George Hull Centre and Turning Point Youth Services, to announce a redeployment of our residential resources. For us, this meant ending operation of our rural site known as “the Farm” and beginning the consolidation of our Intensive services for youth at the Jarvis site in Toronto. At final implementation this change will increase our service capacity by as much as 40 per cent. It will also ensure that the services we offer are more closely aligned to the needs of our current clients. Through increased occupancy of the remaining 12 beds at Jarvis, we will continue to provide residential support to the same number of people each year who particularly need that level of intervention.
Read more about the new service delivery model at SickKids CCMH.
Reducing wait times – a SickKids priority
Since the integration with SickKids in February 2017, SickKids CCMH has had a renewed focused on improving access to care for clients seeking services. In the Outpatient services (OPS) department, this meant staff had to reorganize to ensure that their processes would be efficient and effective in supporting clients with the level of care that they need.
With 2017-18 being a year of discovery and design of the changes needed at SickKids CCMH, this past fiscal year was focused on intentional and deliberate change that would bring about improvement in access to care.
The results are impressive: when a client first called SickKids CCMH in April 2018 they waited, on average, 22 weeks until their first service. In April 2019, that same client will wait 12 weeks – staff have achieved a 45 per cent improvement in wait times and are committed to doing even better.
This substantive progress has been achieved through clinical staff collaboration, moving to a measurement-based culture supported by technology and a commitment to employing LEAN process re-design. Staff realize there is still work to do, but are encouraged by these results which have been achieved in the first two years of being a SickKids-led organization.
New services, faster access – single session clinics
A single session is a two-hour consultation between a family and two therapists, aimed at discussing concerns, highlighting family strengths, offering new perspectives, exploring resources and providing recommendations. This year, single session clinics were introduced and consolidated as an important service line at SickKids CCMH. Rather than assuming all families needed and wanted more long-term, intensive treatments, families are offered a shorter-term service with the option of moving to more intensive treatment if required. For many families, a single, timely session with a therapist is a focused intervention that is goal-oriented and specific to immediate needs. These families experience shorter waits for service with the option of returning should the need arise. The impact for families has been substantial with the majority of new referrals electing to try a single session and only 10 per cent moving directly to the intensive family therapy waiting list which has consequently been reduced by 50 per cent. This updated approach has increased the capacity of SickKids CCMH to provide care to families in a timely and effective way.
Moving towards a measurement-based culture – our quality agenda
This year, SickKids CCMH achieved a successful accreditation with the Council on Accreditation, confirming that the agency meets a high standard for quality and safety across all its departments and activities. This year SickKids CCMH also moved more formally toward a measurement-based culture with the implementation of more formalized key performance indicators. They developed a draft balanced scorecard with key performance indicators focused on wait times, clinical outcomes, and staff and client safety. The scorecard represents the SickKids commitment to measure results and be accountable to clients and families. The 2018-19 draft has evolved into a more formal 2019-20 scorecard that will be published with the SickKids CCMH 2019-20 annual report.
The SickKids CCMH Learning Institute – Broadening our reach
The goal at SickKids CCMH Learning Institute is for training to be accessible to anyone, anywhere. In addition to making training available remotely via webinar, SickKids CCMH Learning Institute is now hosting training in other communities. In March 2019, staff at the institute had the pleasure of partnering with Six Nations Health Services to host the Certificate in Trauma Counselling for Mental Health Professionals six-day course in Ohsweken, Ontario. The training was attended by 63 participants. Institute staff continue to identify opportunities to build partnerships and bring SickKids CCMH Learning Institute training to the community.
SickKids CCMH teaching broader range of future professionals than ever before
SickKids CCMH continues to be dedicated to the teaching and training of future health-care professionals and to learning from each and every learner with whom they engage.
SickKids CCMH placed approximately 120 learners between April 2018 and March 2019 from over 15 different colleges and universities in Ontario. Students came from 11 different disciplines and served clients and their families from all centre programs reaching children all over Toronto and further afield.
Outpatient services welcomed psychology, art and expressive art, social work, occupational therapy and psychiatry trainees. Day treatment and In-home services placed child and youth care students, while Prevention and Early Intervention services took on early childhood education students and a resource teacher trainee. Child and youth care students and a nursing student were located at our city and Farm residential programs. Our Health Information Management and Human Resources teams successfully took on students for the first time.
The City Residential program was proud to have the honour of being nominated by Humber College Child and Youth Care students and to win an award for a Placement of Distinction. This award acknowledged the program and its staff for the outstanding learning experience they provide for Child and Youth Care students.
Upgrading IT to improve access to care and client privacy
This year, there have been a number of IT initiatives at SickKids CCMH. Highlights include the launch of a video conferencing network at SickKids CCMH and an integrated video conference platform with SickKids to provide a foundation for collaboration between staff and greater access to care for clients. This also involved development of new tools to help track a client’s journey from intake to discharge, providing insight into a client’s treatment, results and experience. Further enhancements have been made to the physical and technology infrastructure at SickKids CCMH to bolster the reliability and security of operations and protect clients’ privacy.
Revamping website content with clients and families in mind
Working with the communications team at SickKids, a goal outlined in 2018-19 was to improve content within the design of the current website, making it more relevant and easier to find. Over several months, communications staff gathered information from focus groups and surveys as to what content changes staff, clients and families would like to see. This research will form the basis of change in the next fiscal year so the website can become a better reflection of the Purpose Statement at SickKids CCMH: Commitment to our Community, Building Connections, and Accelerating Impact.