What is the
the SARPEP project?
Evaluate to better support: implementation of a learning system to monitor and guide in real time the implementation of early intervention programs for psychosis. The implementation of first episode psychosis intervention programs (EPIs) throughout Quebec is now a priority for the MSSS, and is well defined by a reference framework. International experience shows that such large-scale implementation represents a considerable challenge. Indeed, EPI models are supported by evidence, such as the one advocated by the MSSS.
Our project is based on an integrated knowledge transfer approach, with the active participation of knowledge users and stakeholders at every stage. Moreover, it is firmly in line with patient-centred research strategies, at the heart of which is the involvement of patients and their families, fostered by researchers, knowledge users and stakeholders alike.
The “SAR” (Rapid Learning System) is defined as an approach in which “science, informatics, enablers and culture come together for continuous improvement and innovation”. While integrating best practices into the care delivery process, the new data captured generates knowledge as an integral by-product of the strategy. A RLS can significantly improve the adoption of clinical guidelines and evidence-based medicine in clinical settings, as well as the translation of knowledge into practice. Rapid Learning Systems have been shown to promote innovation, link evidence to practice, and improve the quality of health care delivery in a variety of physical and mental health settings.
The Rapid Learning System (RLS) will be deployed in 11 Quebec EPIs, selected to provide a representative range of these programs (e.g., urban vs. rural, university vs. non-university affiliation). The RLS will be implemented to allow for a systematic process of data collection on indicators identified from an extensive literature review, practice guidelines and consultation with the stakeholders named above. Examples of indicators are delays in accessing care; components of care received (e.g., pharmacotherapy, cognitive-behavioral psychotherapy, support for return to work, etc.); user satisfaction with their health situation, psychosocial situation and care received), continuing education opportunities for care staff, family involvement, etc.).
Based on the data collected, which will highlight the need for continuing education (area of non-compliance with practice guidelines or lower performance vs. other EPIs), support and training interventions adjusted for each EPI based on their results will be offered for these various indicators.
Systematic data collection on critical indicators of EPI functioning and impact, supported by an electronic platform developed for this purpose. The evaluation includes indicators related to service users, such as patients and family members.
DEPLOYMENT AND CUSTOMIZATION
On the other hand, an assessment is made of the degree of compliance of the interventions provided with the standards concerning the essential components of the EPIs. The deployment and customization of support and knowledge transfer activities aimed at improving performance is assessed through these indicators.
RLS IMPACT ASSESSMENT
An assessment is made of the degree to which the interventions delivered meet the standards for the essential components of the EPIs. Finally, the impact on local and national decision-making processes is analyzed.
JMIR Research Protocols – A Rapid-Learning Health System to Support Implementation of Early Intervention Services for Psychosis in Quebec, Canada: Protocol
Background: Given the strong evidence of their effectiveness, early intervention services (EIS) for psychosis are being widely implemented. However, heterogeneity in the implementation of essential components remains an ongoing challenge. Rapid-learning health systems (RLHSs) that embed data collection in clinical settings for real-time learning and continuous quality improvement can address …