TORONTO, October 11, 2016 - CAMH’s Emergency Department helps some of our most vulnerable clients at critical moments of need – upwards of 900 clients enter its doors each month.
CAMH Emergency Services Manager Marc Greene, CAMH Project Manager Tamar Frank and their colleagues teamed up to introduce a series of improvements to emergency care with the support of CAMH’s clinical information system, I-CARE.
“Many clients are struggling with mental illness over a long period of time and may make repeat visits to emergency during their treatment and recovery,” says Marc. “To get a broader base of knowledge on these clients more quickly, we’ve been working to integrate our care plans and summaries into the I-CARE system.”
A broader base of knowledge: Emergency Services Manager Marc Greene and Project Manager Tamar Frank
Tamar gives the example of a new online “powerform”, which documents a client’s Emergency Care Summary. “This includes crisis intervention strategies related to an individual client, for example, as well as community resources for that person. Now, the Admitting staff can flag this summary so Emergency staff can review that information before they provide care to the client.”
Mark notes: “it can be as simple as knowing that a person who is agitated while visiting our emergency may benefit from some nicotine replacement therapy, which is available promptly here.”
“Whether the issue is big or small, we will now have faster access to that knowledge when the client walks through the door,” he says.
This change is just one of more than 100 significant enhancements to I-CARE made under a project at CAMH this year called I-CARE Optimization. Let’s visit two more program areas to see how Optimization benefits both our clients and clinicians.
The CAMH Clinical Laboratory and Diagnostic Services team completes more than 300,000 tests annually to ensure high-quality care across CAMH treatment programs and to support research studies.
Significant enhancements to the department’s processes – such as much speedier electroencephalogram (EEG) results -- are among a series of strategic improvements delivered by the I-CARE Optimization Project this year.
Faster results to inform treatment: (from left) Trish Szwalek and Susan Estevez of the CAMH Clinical Laboratory, with Project Manager Luanne Choo
“A great example is the recording of electroencephalograms (EEGs), which look at electrical activity in the brain,” says CAMH Lab Technician Susan Estevez. “In our previous process, the CAMH neurologist had to be on site at the lab to view EEG results. With the introduction of a new EEG remote access and reporting process in I-CARE, each final report is now uploaded directly to the client chart.”
“That’s huge,” says Lab Manager Trish Szwalek. “The change means that the neurologist can log in from any location to view results, and physicians can get a faster result to inform treatment for their client. We’re in the process of applying the same principle to the electrocardiogram (ECG) procedures for cardiac monitoring.”
The I-CARE Optimization Project “has also sped up high-volume lab process such as blood and urine-chemistry testing,” notes Project Manager Luanne Choo.
CAMH Project Manager John Fernandes, with Advanced Practice Nurse Sara Ling.
Bringing care information together
“We have developed new ways to bring care information together to be accessible in one spot for the clinician,” notes Project Manager John Fernandes. “One way has been to make our Interprofessional Plans of Care (IPOCs) more accessible and to integrate them with treatment plans. The plan of care sets out important goals and interventions. For example, if a client has an increased risk of suicide, the plan can suggest several interventions for client safety.”
“Better integration of care planning information will mean that a CAMH clinician who’s just meeting a new client can build on a richer base of knowledge, which is based on the client’s previous experience at CAMH,” says Advanced Practice Nurse Sara Ling. She worked with colleagues to introduce improvements for CAMH’s Addiction Medicine Service. “That also means less duplication of effort and more face time with our clients.”
“In all of these changes, the voice of the clinician and needs of the client were really front-and-centre,” says Heather Sulkers, I-CARE Senior Project Manager in the Information Management Group (IMG). More than 90 CAMH clinicians contributed to 18 working groups on issues ranging from admission processes to suicide risk assessment. They worked closely with project staff and the system vendor, Cerner, to deliver big enhancements to CAMH’s system and the care we provide.
CAMH’s Heather Sulkers
Looking ahead, Heather notes CAMH is assessing potential future features for the system that is the data foundation for client care at CAMH. “These include voice recognition, and the identification of patients who are involved in research studies supporting CAMH’s mission.”