EPION Spotlight on… SISC Fidelity Pilot: Who

We can see the impact of the fidelity assessment on multiple levels within the EPI community. The direct impact is on the programs being assessed, but as we take a closer look, the ripple effects reach the assessors themselves, the sector as a whole, and the people we provide services to. Let’s take a closer look at how this process impacts all these different stakeholders. 

Who’s benefiting from the fidelity testing?

We can see the impact of the fidelity assessment on multiple levels within the EPI community. The direct impact is on the programs being assessed, but as we take a closer look, the ripple effects reach the assessors themselves, the sector as a whole, and the people we provide services to. Let’s take a closer look at how this process impacts all these different stakeholders.

The Programs Assessed:

“The fidelity assessment is not an exercise in judgement” (Krista Whittard, Manager of the Mental Health Program’s Clinical Services, Niagara Region). Some EPI staff members were nervous going into the assessment. At first glance it can feel like an evaluation, but in actuality, programs have described it as a very positive experience that allows programs to highlight the idiosyncrasies and innovations that that make them unique within the EPI community. This is extremely important, because even though EPI programs strive to be “Fidelicious,” as our PSSP assessor team has lightheartedly termed it around the office, each program can still do that in their own unique way (Sandy Brooks). This process is an opportunity for programs to showcase their distinctive set of competencies, passions and strengths to the rest of the EPI community so we can all learn from each other.

The fidelity assessment also provides the opportunity to re-evaluate what you have been doing, and think about how you improve (as we all know, every program always has room for improvement).  It is an opportunity critically reflect on the services you have been providing and set clear direction for change. These changes might include larger improvement projects or they can be minor tweaks that still go a long way to improving the experience of our clients. One unique experience was the opportunity for two programs to collaborate, share resources, and adopt a peer mentor role to one another; this opportunity was identified as a source of pride for the programs.

A potent theme that was heard from programs that received an assessment was that this process is an exercise in validation.

The Assessors:

Not only is this process positive for programs, but it has had a re-energizing effect on the individual EPI practitioners who have been trained as assessors. Assessors expressed feeling of connection to the EPI community as a result of receiving “this interesting and unique training as I was able to network with all the other assessors and program participants involved” (Josette Morin, Nurse Educator at the Regional Early Intervention in Psychosis Program, North Bay Regional Health Centre); she enjoyed the opportunity for establishing personal connections, and putting faces to names.

A highlight for Sandy Brooks, one of the PSSP assessors, was when she was “Watching the people that she was doing the assessments with, watching the networking that was going on, such as the exchanging of ideas, and as this was occurring you could see the light bulbs coming on.”

This moment epitomizes the passion demonstrated every day by our EPI community. The added bonus was that people went in as assessors, but “came out with really good ideas for your own program” and a sense of camaraderie.

The Sector:

For the EPI sector as a whole, the fidelity assessments are important to ensure consistent services across the province, supporting high quality care, and making it easier for individuals who are transferring among programs. They can also help identify common challenges across programs that could be addressed by the LHINs or MOHLTC at a sector level. By focusing on adherence to provincial standards fidelity work can help stakeholders to see the relevance of the standards themselves, and the potential to update or refresh the standards to stay current.

People experiencing their first episode of psychosis and their families:

The ultimate impact occurs for the people who are receiving EPI services, the person experiencing their first episode of psychosis, and their families. When we can demonstrate that we are doing what we are supposed to be doing, it establishes a confidence in the work that we do, and a hope for families that the early intervention will be successful. Through the fidelity process, and the networking, it has prompted programs to begin thinking innovatively, bigger, about how programs can support people across Ontario who have similar experiences.

One thing that Josette Morin, coordinator of the North East Regional Program, will never forget is an interview with a psychiatrist from one of the programs being assessed who expressed “when the youth come to us, it is likely their first experience with mental health services so we have to make sure it’s a good one!” This stood out to Josette because people are experiencing the impact and the suffering associated with a first episode of psychosis, and the EPI community are here for the same reason, we want to provide the best care possible.

Keep your eye out for our update in October highlighting the training for our new assessors, and our assessor team!

For more information about the EPION SISC Working Group, please contact:
Avra Selick, EPION Research Coordinator – Avra.Selick@camh.ca

Suggested reading:

• Ontario’s Early Psychosis Intervention Standards, 2011 (MOHLTC)
• Early Psychosis Intervention: Fidelity Assessments in Ontario, 2018 (EPION via IEPA)